Individual
MARGUERITE M ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
412 W KINNE ST, ELLSWORTH, WI 54011
(715) 273-6770
(715) 273-6862
Mailing address
PO BOX 670, ELLSWORTH, WI 54011-0670
(715) 273-6770
(715) 273-6770
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12268
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7304-123
MENTAL HEALTH
WI
Enumeration date
11/16/2006
Last updated
07/08/2007
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