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Individual

PAULINE E. LIESENFELT

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.S.W.

Contact information

Practice address
2321 STOUT RD, MENOMONIE, WI 54751-7003
(715) 235-5531
(715) 233-7645
Mailing address
2321 STOUT RD, MENOMONIE, WI 54751-7003
(715) 235-5531
(715) 233-7645

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3141-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43556900
WI
Enumeration date
06/05/2006
Last updated
07/08/2007
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