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General NPI Number Information
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NPI Number | 1255079745
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Entity Type | Organization
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Legal Business Name | I AM AUTISM LLC
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Dates
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Enumeration Date | 05/24/2022
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Last Update Date | 05/24/2022
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Provider Practice Location Address
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Address Line | 7818 BIG SKY DR STE 213
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City | MADISON
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State | WI
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Zip | 53719-2840
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Country | US
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Telephone | 608-291-3857
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Fax |
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Provider Business Mailing Address
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Address Line | 2044 CONTINENTAL LN
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City | CROSS PLAINS
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State | WI
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Zip | 53528-9123
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Country | US
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Telephone | 608-558-0383
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | RACHEL A MOREHOUSE
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Credential | LMFT
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Telephone | 608-558-0383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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