Individual
PHILIP CHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LCSW
Contact information
Practice address
1177 QUAIL CT, SUITE 101, PEWAUKEE, WI 53072-3790
(262) 247-0269
Mailing address
1177 QUAIL CT, SUITE 101, PEWAUKEE, WI 53072-3790
(262) 247-0269
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2206-123
WI
Other
Enumeration date
01/16/2012
Last updated
01/16/2012
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