| Wisconsin Young Autism Project | |
|
6402 Odana Rd Madison WI 53719-1123 | |
| (608) 288-9040 | |
| (608) 288-9042 |
| Full Name | Wisconsin Young Autism Project |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 6402 Odana Rd, Madison, Wisconsin |
| Authorized Official Name and Position | Kim Lauree Schutt-chardon (DIRECTOR OF BILLING) |
| Authorized Official Contact | 6082889040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisconsin Young Autism Project 6402 Odana Rd Madison WI 53719-1123 Ph: (608) 288-9040 | Wisconsin Young Autism Project 6402 Odana Rd Madison WI 53719-1123 Ph: (608) 288-9040 |
| NPI Number | 1023283397 |
|---|---|
| Provider Enumeration Date | 04/28/2008 |
| Last Update Date | 04/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023283397 | NPI | - | NPPES |
| 42223400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (Wisconsin) | Primary |
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