Provider Demographics
NPI:1326685702
Name:MADSEN, VALERIE (MS CTRS)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:MADSEN
Suffix:
Gender:F
Credentials:MS CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 WEST ST
Mailing Address - Street 2:
Mailing Address - City:WONEWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53968-9076
Mailing Address - Country:US
Mailing Address - Phone:608-285-2440
Mailing Address - Fax:
Practice Address - Street 1:317 WEST ST
Practice Address - Street 2:
Practice Address - City:WONEWOC
Practice Address - State:WI
Practice Address - Zip Code:53968-9076
Practice Address - Country:US
Practice Address - Phone:608-285-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist