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Individual

SHANNON COLE-CAMERON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
1100 LAKE VIEW DR, WAUSAU, WI 54403-6785
(715) 848-4600
(715) 845-5398
Mailing address
1100 LAKE VIEW DR, WAUSAU, WI 54403-6785
(715) 848-4600
(715) 845-5398

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7904
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7904-123
STATE LICENSE - LCSW
WI
Enumeration date
05/02/2013
Last updated
03/01/2016
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