| Self & Others | |
|
702 N Blackhawk Ave Ste 100 Madison WI 53705-3357 | |
| (608) 628-1307 | |
| (608) 663-5928 |
| Full Name | Self & Others |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 702 N Blackhawk Ave Ste 100, Madison, Wisconsin |
| Authorized Official Name and Position | Steven M Blank (OWNER) |
| Authorized Official Contact | 6086281307 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Self & Others 702 N Blackhawk Ave Ste 100 Madison WI 53705-3357 Ph: (608) 628-1307 | Self & Others 702 N Blackhawk Ave Ste 100 Madison WI 53705-3357 Ph: (608) 628-1307 |
| NPI Number | 1326720772 |
|---|---|
| Provider Enumeration Date | 08/04/2023 |
| Last Update Date | 06/27/2024 |
| Certification Date | 06/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326720772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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