Individual
LISA DUNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-7424
(920) 674-7409
Mailing address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-7424
(920) 674-7409
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7851-123
WI
Other
Enumeration date
09/17/2012
Last updated
02/09/2015
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