Individual
DIANE CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 N 6TH ST, WAUSAU, WI 54403-5519
(715) 261-8808
Mailing address
115 N 6TH ST, WAUSAU, WI 54403-5519
(715) 261-8808
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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