| NPI | 1093256604 |
|---|---|
| Former Legal Business Name | MADISON TRAUMA THERAPY LLC |
| Entity Type | Organization |
| Authorized Contact | NICOLE E MOLL Owner 608-419-6103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2023-12-04 |