Individual provider · Type 1 NPI

Lisa Marie Moon

Addiction (Substance Use Disorder) Counselor · Madison, WI

NPI number 1699340075 Active

Practice location

5005 University Ave
Madison, WI 53705-5439

Fax (608) 233-2021

Mailing address

1021 N Mulford Rd
Rockford, IL 61107-3874

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X19349-130 (WI)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1699340075

Lisa Marie Moon's National Provider Identifier is 1699340075, issued on May 26, 2021. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Madison, WI. The record was last updated on May 26, 2021.