Individual
DOREEN K ELDRED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
143 S GIBSON ST, MEDFORD, WI 54451-1622
(715) 748-2121
(715) 748-7590
Mailing address
143 SOUTH GIBSON STREET, MEDFORD, WI 54451-1622
(715) 748-2121
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
726
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39239200
—
WI
Enumeration date
08/11/2006
Last updated
05/22/2012
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