Individual
MRS. JACKIE CEILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1614 E MARION ST, SHOREWOOD, WI 53211-1519
(414) 465-3266
Mailing address
1614 E MARION ST, SHOREWOOD, WI 53211-1519
(414) 465-3266
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
154-122
WI
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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