Individual
MARY E SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PC
Contact information
Practice address
6502 GRAND TETON PLZ STE 102, MADISON, WI 53719-1047
(608) 827-7220
(608) 827-7223
Mailing address
1 LANGDON ST APT 104, MADISON, WI 53703-1314
(608) 469-0966
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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