Provider Demographics
NPI:1407175250
Name:MANDT, CATHERINE ENOS (MS, MA)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ENOS
Last Name:MANDT
Suffix:
Gender:F
Credentials:MS, MA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6000 MONONA DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MONONA
Mailing Address - State:WI
Mailing Address - Zip Code:53716-3327
Mailing Address - Country:US
Mailing Address - Phone:608-223-9767
Mailing Address - Fax:608-223-9767
Practice Address - Street 1:6000 MONONA DR
Practice Address - Street 2:SUITE 203
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53716-3327
Practice Address - Country:US
Practice Address - Phone:608-223-9767
Practice Address - Fax:608-223-9767
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI311792101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional