Individual
LAURA ANN BAMBROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, APSW
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-8124
Mailing address
3825 MONONA DR APT 12, MONONA, WI 53714-2845
(608) 669-4524
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
129983
WI
Other
Enumeration date
07/09/2020
Last updated
07/09/2020
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