Individual
JILL BLANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,LCSW
Contact information
Practice address
1020 KABEL AVE, RHINELANDER, WI 54501
(715) 361-2805
Mailing address
1020 KABEL AVE, RHINELANDER, WI 54501-3918
(715) 361-2805
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7756
WI
1041C0700X
Clinical Social Worker
149003320
IL
Other
Enumeration date
10/11/2007
Last updated
09/28/2018
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