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Individual

KAL SHORE WOGAHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
X
Credential
LPC

Contact information

Practice address
1882 E MAIN ST STE 202, MADISON, WI 53704-5288
(608) 284-8271
Mailing address
1882 E MAIN ST STE 202, MADISON, WI 53704-5288
(608) 284-8271

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
11242-125
WI
101YP2500X
Professional Counselor
7220
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11242-125
WI DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES
WI
Enumeration date
01/31/2023
Last updated
08/23/2024
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