Individual
MISS JOHANNAH MICHAEL THEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2500 OVERLOOK TER, MADISON, WI 53705-2254
(608) 256-1901
Mailing address
2564 BRANCH ST APT 10, MIDDLETON, WI 53562-2851
(715) 563-4720
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/01/2021
Last updated
12/01/2021
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