Individual
EMILY BEBOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1095 MIDWAY RD, MENASHA, WI 54952-1115
(920) 720-2300
Mailing address
W776 APACHE AVE, FREMONT, WI 54940-8554
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
130067
WI
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
12/07/2023
Last updated
01/30/2024
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