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Individual

MS. MARNIE LOUISE HERSRUD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
2004 HIGHLAND AVE, SUITE N, EAU CLAIRE, WI 54701-4400
(715) 835-5915
(715) 835-8112
Mailing address
3231 LOCUST LN, EAU CLAIRE, WI 54703-1158
(715) 833-9729

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1815-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1815-123
LCSW
WI
05
39559200
WI
Enumeration date
08/20/2006
Last updated
07/08/2007
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