Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 5032-27 | WI |
NPI | 1629475470 |
---|---|
Provider Name | Steve C Chappell |
First Address | Madison, WI 53711-6227 |
Second Address | Madison, WI 53703-1524 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2014 |
Last Update Date | 13/09/2016 |