Individual
MARILYN N. VIDERGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, APSW
Contact information
Practice address
500 RIVERVIEW AVE, WAUKESHA, WI 53188-3632
(262) 548-7363
(262) 548-7643
Mailing address
500 RIVERVIEW AVE, WAUKESHA, WI 53188-3632
(262) 548-7363
(262) 548-7643
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
176-121
WI
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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