Westside Psychotherapy Llc

NPI 1558769364 - Psychologist - 103T00000X

NPI Details
NPI 1558769364
Enumeration Date 12/10/2014
Last Updated 12/10/2014
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name SANDRA SANDRA
Position OWNER
Phone (608) 236-4460
Fax (608) 236-4461
Practice Location
313 PRICE PL
SUITE 208
MADISON WI, 53705-3299, US
Phone (608) 236-4460
Fax (608) 236-4461
Business Location
313 PRICE PL
SUITE 208
MADISON WI, 53705-3299, US
Phone (608) 236-4460
Fax (608) 236-4461
Toxanomy
Taxonomy Code 103T00000X
License State Wisconsin
License Number 2043
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According to our database, Westside Psychotherapy Llc NPI is 1558769364, taxonomy code is 103T00000X and license number is 2043, license state is located at Wisconsin. Westside Psychotherapy Llc physically located at 313 Price Pl, Madison WI, 53705-3299. NPI Number 1033115704 has the healthcare provider type.

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1558769364 NPI number is provided on an as is basis without warranty of any kind. 1558769364 is maintained by the National Plan & Provider Enumeration System. The contents of Westside Psychotherapy Llc are for informational purposes only.