Individual
EMMA SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT-IT
Contact information
Practice address
307 S PATERSON ST STE 120, MADISON, WI 53703-3517
(608) 501-1629
Mailing address
107 RIVERSIDE DR, MADISON, WI 53704-5235
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1104-228
WI
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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