Individual
PEGGY NIES SCARGALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, CADC, CAPSW
Contact information
Practice address
888 THACKERAY TRL STE 211, OCONOMOWOC, WI 53066-4342
(262) 613-0918
Mailing address
888 THACKERAY TRL STE 211, OCONOMOWOC, WI 53066-4342
(262) 613-0918
(262) 646-6284
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
12735
WI
104100000X
Social Worker
Primary
2011-121
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390808738005
BLUE CROSS
—
05
—
40929300
—
WI
Enumeration date
07/18/2006
Last updated
07/21/2020
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