Individual
MARY ELDRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1067 DERBY DR, SUN PRAIRIE, WI 53590-2457
(281) 635-9996
Mailing address
1067 DERBY DR, SUN PRAIRIE, WI 53590-2457
(281) 635-9996
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9589-123
WI
Other
Enumeration date
12/23/2021
Last updated
12/29/2021
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