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Individual

LISA RENAE JEFFERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CAPSW

Contact information

Practice address
500 E VETERANS ST, TOMAH, WI 54660-3105
(608) 372-3971
(608) 372-1646
Mailing address
961 OAK AVE N, ONALASKA, WI 54650-2196
(608) 387-5493

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
131995-121
WI

Other

Enumeration date
09/09/2022
Last updated
09/09/2022
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