Individual
MS. LISA ANN MAGNUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, SAC
Contact information
Practice address
5900 S LAKE DR, CUDAHY, WI 53110-3171
(414) 489-4421
(414) 489-4056
Mailing address
564 E JORDAN LN, OAK CREEK, WI 53154-7082
(414) 570-6049
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1648-123, 13932-131
WI
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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