Individual
BLAKE STAUTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 RAYOVAC DR, #103, MADISON, WI 53711
(608) 238-5826
Mailing address
W9605 IVAN ST, CAMBRIDGE, WI 53523-9021
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
WI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
WI
Other
Enumeration date
04/22/2026
Last updated
05/13/2026
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