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Individual

WANDA JEAN SCHAFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
1707 MAIN ST, LA CROSSE, WI 54601-4200
(608) 788-6322
(608) 785-0002
Mailing address
66 E 3RD ST, 2, WINONA, MN 55987-3478
(507) 452-7292
(507) 457-9887

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3847-123
WI
106H00000X
Marriage & Family Therapist
63-124
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
016L6SC
BLUE CROSS BLUE SHIELD
MN
05
39281800
WI
Enumeration date
08/15/2006
Last updated
01/08/2008
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