|Taxonomy Code||Specialty Code||Provider Type|
|1041C0700X||80||Licensed Clinical Social Worker|
|LBN Legal business name||WUBBENHORST & WUBBENHORST, INC|
|DBA Doing business as||MADISON AVENUE PSYCHOLOGICAL SERVICES|
|Authorized official||JOHN WUBBENHORST - (PRESIDENT)|
|Organization subpart 1||No|
|Last updated||10/29/2012 - About 4 years ago|
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|CYNTHIA L SCHNACKE, PhD
TEAKWOOD PSYCHOLOGICAL RESOURCES
|ELLA P SQUYRES, LSCSW
|MICHELE DUBUISSON, LCSW
2334 W. LAWRENCE AVE.
|HEATHER M WATERMAN, LMSW
235 S. KANSAS AVE
|TAMEKA MCCRAY, LBSW,MSW
235 S KANSAS AVE,
|MICHELLE R HERNANDEZ, LMSW
235 S. KANSAS AVE.
|MILFRED D DALE, PHD
2201 SW 29TH STREET
|TAMMIE L WOLF, LSCSW
2201 SW 29TH ST
|HEATHER M PRICHARD, TLMSW, LBSW
2906 SW MEDFORD AVE
|JAMES W FOX, BAS, T-LAC, PCCM,
4015 SE 21 ST