Individual
MRS. GLORIA JEAN MANADIER-FARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
1502 GREENWAY CROSS STE 101B, MADISON, WI 53713-5023
(608) 237-6317
(877) 822-7631
Mailing address
1502 GREENWAY CROSS STE 101B, MADISON, WI 53713-5023
(608) 237-6317
(877) 822-7631
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
14351-132
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14351-132
WI
101YM0800X
Mental Health Counselor
14351-132
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12809-133
STATE OF WISCONSIN DEPARTMENT OF REGUALTION AND LICENSING
WI
01
—
14351-132
STATE OF WISCONSIN DEPARTMENT OF REGUALTION AND LICENSING
WI
Enumeration date
12/16/2008
Last updated
12/16/2008
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