| Organization Name: | MONONA MEDIATION AND COUNSELING LLC |
| NPI Number: | 1073849717 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENNETH HUGH WALDRON (OWNER-PSYCHOLOGIST) |
| Mailing Address: | 6320 Monona Dr Ste 314 Monona |
| State: | WI US |
| Postal Code: | 537163985 |
| Phone Number: | 6084423420 |
| Fax Number: | 6084433421 |
| NPI Enumeration Date: | 10/31/2009 |
| NPI Last Update Date: | 10/31/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 913-123 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |