Individual
LISA DIANE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
W3950 WI-23 TRUNK, FOND DU LAC, WI 54937
(877) 300-9101
Mailing address
E7475 RAWHIDE RD, NEW LONDON, WI 54961-9025
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13056-120
WI
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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