Individual
LEAH BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2935 S FISH HATCHERY RD # 244, MADISON, WI 53711
(608) 352-9048
Mailing address
2935 S FISH HATCHERY RD # 244, MADISON, WI 53711
(608) 352-9048
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
691-228
WI
Other
Enumeration date
05/29/2019
Last updated
08/21/2020
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