Individual
GINA PATOVISTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6673
Mailing address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6673
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7915-123
WI
Other
Enumeration date
03/01/2013
Last updated
08/02/2013
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