| Familypath Autism Services, Llc | |
|
575 Donofrio Dr Ste 101 Madison WI 53719-2832 | |
| (608) 512-0780 | |
| (608) 841-1059 |
| Full Name | Familypath Autism Services, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 575 Donofrio Dr Ste 101, Madison, Wisconsin |
| Authorized Official Name and Position | Connie Thomas (MEMBER) |
| Authorized Official Contact | 6085132272 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Familypath Autism Services, Llc 575 Donofrio Dr Ste 101 Madison WI 53719-2832 Ph: (608) 512-0780 | Familypath Autism Services, Llc 575 Donofrio Dr Ste 101 Madison WI 53719-2832 Ph: (608) 512-0780 |
| NPI Number | 1457756595 |
|---|---|
| Provider Enumeration Date | 10/31/2014 |
| Last Update Date | 05/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457756595 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 222957 (Wisconsin) | Secondary |
| 106H00000X | Marriage & Family Therapist | 674124 (Wisconsin) | Primary |
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