Individual
SHANNON BERNICE WESTPHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
139 NORTH LAKE STREET, HUSTISFORD, WI 53034-9507
(262) 226-0391
(920) 349-9031
Mailing address
PO BOX 131, HUSTISFORD, WI 53034-0131
(262) 224-7721
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
131945
WI
1041C0700X
Clinical Social Worker
Primary
10144-123
WI
Other
Enumeration date
04/06/2021
Last updated
11/16/2023
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