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Individual

MS. MICHELLE LEE SIVANICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BSW IN SOCIAL WORK

Contact information

Practice address
1407 SAINT ANDREW ST STE 100, LA CROSSE, WI 54603-2378
(608) 785-6265
Mailing address
1006 ROSE ST, LA CROSSE, WI 54603-2537
(608) 782-1821

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
10631-120
WI

Other

Enumeration date
11/08/2010
Last updated
12/02/2010
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