Individual
MR. ELMER B WANNEMUEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
414 SE FOURTH STREET, EVANSVILLE, IN 47713
(812) 423-4700
(812) 421-2618
Mailing address
414 SE FOURTH STREET, EVANSVILLE, IN 47713
(812) 423-4700
(812) 421-2618
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34002742A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000301644
ANTHEM BCBS
IN
Enumeration date
09/08/2006
Last updated
07/08/2007
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