Individual
TIMOTHY JAY BAUTCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C., S.A.C.-I.T.
Contact information
Practice address
1334 APPLEGATE RD STE 101, MADISON, WI 53713-5008
(608) 221-1500
(608) 221-1515
Mailing address
1334 APPLEGATE RD STE 101, MADISON, WI 53713-5008
(608) 221-1500
(608) 221-1515
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
14528
WI
101YM0800X
Mental Health Counselor
Primary
3921-125
WI
Other
Enumeration date
10/04/2007
Last updated
10/04/2007
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