Provider Demographics
NPI:1386029510
Name:MARKING, MICHELLE
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MARKING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 PRICE PL
Mailing Address - Street 2:SUITE 10
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3299
Mailing Address - Country:US
Mailing Address - Phone:608-231-3300
Mailing Address - Fax:608-231-0644
Practice Address - Street 1:313 PRICE PL
Practice Address - Street 2:SUITE 10
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3299
Practice Address - Country:US
Practice Address - Phone:608-231-3300
Practice Address - Fax:608-231-0644
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI31441231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical