Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 1096 | WI |
Y | 103TC0700X | Clinical Psychologist | 1096 | WI |
N | 103TC1900X | Counseling Psychologist | 1096 | WI |
N | 174V00000X | Clinical Ethicist | ||
N | 225400000X | Rehabilitation Practitioner |
NPI | 1407327844 |
---|---|
Provider Name | Dr. Deborah Ann Pape |
First Address | Madison, WI 53703 |
Second Address | Madison, WI 53703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2018 |
Last Update Date | 11/12/2018 |