Individual
AUDRA A EGGUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
140 W MAIN ST, SUITE A, WINNECONNE, WI 54986-9409
(920) 582-4000
Mailing address
PO BOX 486, 140 W MAIN, WINNECONNE, WI 54986-0486
(920) 582-4000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
1556-121
WI
1041C0700X
Clinical Social Worker
Primary
7281-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40923500
—
WI
Enumeration date
05/11/2007
Last updated
01/25/2011
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