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1962057463
SHADOW BACKUS
MADISON, WI
NPI
1962057463
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: WI 6526-123)
Enumeration Date
2019-08-02
Last Update Date
2020-02-04
Business Address
SHADOW BACKUS LCSW, LMT
34 SCHROEDER CT
MADISON, WI 53711-2526
Phone number: 608-409-3400
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Mailing Address
SHADOW BACKUS LCSW, LMT
1041 GALWAY AVE
WAUNAKEE, WI 53597-8956
Phone number: 608-409-3400
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