Individual
MS. CAROLYN RAE BLACKDEER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
500 E VETERANS ST, TOMAH, WI 54660-3105
(608) 372-3971
Mailing address
27824 EPIC AVE, TOMAH, WI 54660-4505
(612) 221-9364
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9774-123
WI
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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