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1699340075
LISA MARIE MOON
MADISON, WI
NPI
1699340075
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 19349-130)
Enumeration Date
2021-05-26
Last Update Date
2021-05-26
Business Address
LISA MARIE MOON
5005 UNIVERSITY AVE
MADISON, WI 53705-5439
Phone number: 608-233-2100
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Mailing Address
LISA MARIE MOON
1021 N MULFORD RD
ROCKFORD, IL 61107-3874
Phone number:
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