Wisconsin Early Autism Project | |
1210 Fourier Drive Suite #100 Madison WI 53717-1969 | |
(608) 662-9327 | |
(608) 662-9041 |
Full Name | Wisconsin Early Autism Project |
---|---|
Speciality | Psychologist - Clinical |
Location | 1210 Fourier Drive, Madison, Wisconsin |
Authorized Official Name and Position | Kim Lauree Schutt-chardon (DIRECTOR OF BILLING) |
Authorized Official Contact | 6086629327 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Wisconsin Early Autism Project 1210 Fourier Drive Suite #100 Madison WI 53717-1969 Ph: (608) 662-9327 | Wisconsin Early Autism Project 1210 Fourier Drive Suite #100 Madison WI 53717-1969 Ph: (608) 662-9327 |
NPI Number | 1043406978 |
---|---|
Provider Enumeration Date | 09/25/2007 |
Last Update Date | 11/17/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043406978 | NPI | - | NPPES |
42223400 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | HFS 61.91 (Wisconsin) | Primary |
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