Individual
PENNIE LYNN BERNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
1407 SAINT ANDREW ST, SUITE 100, LA CROSSE, WI 54603-3301
(888) 742-5510
Mailing address
814 CENTRAL AVE, SPARTA, WI 54656-1509
(608) 633-0908
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
7457-120
WI
Other
Enumeration date
01/06/2009
Last updated
01/06/2009
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