Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 4808-226 | WI |
N | 225C00000X | Rehabilitation Counselor | 446021 |
NPI | 1255902615 |
---|---|
Provider Name | Courtney Marie Schmidt |
First Address | Madison, WI 53704-2206 |
Second Address | Monona, WI 53716-3561 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2021 |
Last Update Date | 07/07/2021 |