Individual
STEPHANIE L SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 PARK RIDGE LN, NORTH FOND DU LAC, WI 54937-1385
(920) 926-7800
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(920) 926-7800
(920) 921-3500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9382-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100099738
—
WI
Enumeration date
03/26/2020
Last updated
07/09/2020
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