Organization
KINTSUGI MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME LAM PHD, LP (OWNER/LICENSED PSYCHOLOGIST)
(781) 698-9171
Entity
Organization
Contact information
Practice address
119 MARTIN LUTHER KING JR BLVD STE LL-20, MADISON, WI 53703-3355
(608) 291-3586
Mailing address
5902 TOLMAN TER, MADISON, WI 53711-3360
(781) 698-9171
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
01/30/2024
Last updated
03/06/2024
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