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Individual

KIM RICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1015 GAMMON LN, MADISON, WI 53719-2210
(608) 417-8144
(608) 271-3457
Mailing address
1015 GAMMON LN, MADISON, WI 53719-2210
(608) 417-8144
(608) 271-3457

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
805
WI
101YM0800X
Mental Health Counselor
3203
WI

Other

Enumeration date
02/20/2014
Last updated
02/20/2014
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