Healthcare Provider Details

I. General information

NPI: 1073931051
Provider Name (Legal Business Name): MONIKA URENA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 12/01/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 RESEARCH PARK BLVD
MADISON WI
53719
US

IV. Provider business mailing address

7974 UW HEALTH CT
MIDDLETON WI
53562-5531
US

V. Phone/Fax

Practice location:
  • Phone: 608-232-3171
  • Fax: 608-262-9246
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number941-124
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: