Individual
JENNIFER L STAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6040 W LISBON AVE, SUITE 103, MILWAUKEE, WI 53210-2116
(414) 442-1751
(414) 442-1775
Mailing address
6040 W LISBON AVE STE 103, MILWAUKEE, WI 53210-2116
(414) 442-1751
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8864-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43730200
—
WI
Enumeration date
03/06/2007
Last updated
08/27/2021
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