Individual
STACY BAMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
404 N MAIN ST STE 503, OSHKOSH, WI 54901-4952
(920) 428-4298
Mailing address
1037 CARRIAGE LN, FOND DU LAC, WI 54935-6556
(920) 428-4298
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8792-123
WI
Other
Enumeration date
01/02/2015
Last updated
02/22/2022
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