MR. Brody Thomas Fanshaw, MS, LPC
NPI #1689390981 in Sun Prairie, Wisconsin
Provider Information
- NPI Number
- 1689390981
- Entity Type
- Individual
- Name
- MR. Brody Thomas Fanshaw, MS, LPC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Mental Health
- Credential
- MS, LPC
- Enumeration Date
- Oct 18, 2022
- Last Updated
- Aug 14, 2024
Practice Location
- Address
- 121 S BRISTOL ST STE 102
- City
- Sun Prairie
- State
- Wisconsin
- ZIP Code
- 53590-2995
- Phone
- (608) 285-2911
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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