Individual
MIKAYLA T PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT-IT
Contact information
Practice address
437 S YELLOWSTONE DR STE 217B, MADISON, WI 53719-1061
(608) 467-2332
Mailing address
437 S YELLOWSTONE DR STE 217B, MADISON, WI 53719-1061
(608) 467-2332
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
09/05/2019
Last updated
12/24/2021
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