Individual
MACKENZIE WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 RAY O VAC DR STE 320, MADISON, WI 53711-2471
(608) 520-0846
Mailing address
6 LUKKEN CT, MADISON, WI 53704-3531
(715) 305-2424
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7875-226
WI
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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