Individual
EMILY ROSE MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2207 E 5TH ST, SUPERIOR, WI 54880-3708
(715) 919-0748
Mailing address
7744 E CTY RD V, SOUTH RANGE, WI 54874
(715) 919-0748
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11691-123
WI
Other
Enumeration date
04/19/2024
Last updated
04/19/2024
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