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NPI 1043985062

NPI 1043985062 : RAPE CRISIS CENTER INC : MADISON, WI

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General NPI Number Information
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    NPI Number           |    1043985062
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    Entity Type          |    Organization 
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    Legal Business Name  |    RAPE CRISIS CENTER INC 
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Dates
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    Enumeration Date     |    08/11/2021
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    Last Update Date     |    08/11/2021
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Provider Practice Location Address
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    Address Line         |    2801 COHO ST STE 301 
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    City                 |    MADISON
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    State                |    WI
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    Zip                  |    53713-1486
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    Country              |    US
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    Telephone            |    608-251-5126
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2801 COHO ST STE 301 
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    City                 |    MADISON
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    State                |    WI
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    Zip                  |    53713-1486
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    Country              |    US
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    Telephone            |    608-251-5126
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CO-EXECUTIVE DIRECTOR
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    Name                 |     DANA MARESSA PELLEBON 
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    Credential           |    
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    Telephone            |    608-575-1074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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