Individual
KRYSTINA KYLENE HANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1030 BULTMAN RD, MADISON, WI 53704-8933
(920) 217-0401
Mailing address
1030 BULTMAN RD, MADISON, WI 53704-8933
(920) 217-0401
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5164-125
WI
Other
Enumeration date
06/05/2013
Last updated
04/23/2014
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