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General NPI Number Information
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NPI Number | 1205662459
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Entity Type | Organization
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Legal Business Name | HANNAH ETHUN PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 09/12/2024
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 1930 MONROE ST
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City | MADISON
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State | WI
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Zip | 53711-2059
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Country | US
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Telephone | 608-963-5594
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Fax |
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Provider Business Mailing Address
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Address Line | 7103 NORTH AVE
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City | MIDDLETON
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State | WI
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Zip | 53562-2740
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | HANNAH ETHUN
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Credential |
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Telephone | 608-963-5594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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