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Individual

ELIZABETH ANN LIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MFT

Contact information

Practice address
629 RIVER ST, BELLEVILLE, WI 53508-9189
(608) 424-9100
Mailing address
1601 PORTER AVE, MADISON, WI 53704-3828
(330) 245-6746

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
776-228
WI

Other

Enumeration date
08/16/2021
Last updated
08/16/2021
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