Healthcare Provider Details

I. General information

NPI: 1790883049
Provider Name (Legal Business Name): MRS. ERIN L HOTLEN-YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 ODANA CT
MADISON WI
53719-1120
US

IV. Provider business mailing address

5 ODANA CT
MADISON WI
53719-1120
US

V. Phone/Fax

Practice location:
  • Phone: 608-277-0610
  • Fax:
Mailing address:
  • Phone: 608-277-0610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7126-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: