Organization
MOSTON LEGACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOLLY SPAENI MS, LMFT (MARRIAGE AND FAMILY THERAPIST)
(608) 305-4221
Entity
Organization
Contact information
Practice address
740 REGENT ST STE 105, MADISON, WI 53715-2648
(608) 305-4221
Mailing address
740 REGENT ST STE 105, MADISON, WI 53715-2648
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
02/05/2024
Last updated
10/15/2024
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