BRODY THOMAS FANSHAW

SUN PRAIRIE, WI
NPI1689390981
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: WI  7151-226)
Enumeration Date2022-10-18
Last Update Date2024-08-14
Business Address
Mr. BRODY THOMAS FANSHAW MS, LPC
121 S BRISTOL ST STE 102
SUN PRAIRIE, WI 53590-2995
Phone number: 608-285-2911
Mailing Address
Mr. BRODY THOMAS FANSHAW MS, LPC
6408 BRIDGE RD APT 245
MONONA, WI 53713-1832
Phone number: 608-285-2911
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