Organization
ANGELIC AWAKENINGS, INC
Active
Other names
Inner Essence Center
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINE GAY MSSW (PRESIDENT)
(608) 345-3552
Entity
Organization
Contact information
Practice address
319 SETH CIR, MADISON, WI 53716-2120
(608) 345-3552
Mailing address
319 SETH CIR, MADISON, WI 53716-2120
(608) 345-3552
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2437-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42197500
—
WI
01
—
WI2256
MEDICARE PTAN
WI
Enumeration date
03/10/2007
Last updated
09/09/2011
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