Individual
MS. CIEL ISHATOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LMFT
Contact information
Practice address
1619 MONROE ST, MADISON, WI 53711-2063
(608) 255-9330
(608) 255-7810
Mailing address
4704 WINNEQUAH RD, MONONA, WI 53716-2030
(608) 255-9330
(608) 255-7810
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2248-123
WI
106H00000X
Marriage & Family Therapist
261-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39255100
—
WI
Enumeration date
06/10/2006
Last updated
07/15/2007
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