Individual
MS. DIANE JOY MROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2350 SOUTH AVE, LA CROSSE, WI 54601-6272
(715) 838-9856
(715) 838-7289
Mailing address
1320 W CLAIREMONT AVE, SUITE 200, EAU CLAIRE, WI 54701-4566
(715) 834-2046
(715) 834-7563
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
911-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39556000
—
WI
Enumeration date
11/14/2006
Last updated
07/08/2007
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