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Individual

MARLENE DIANE VAIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
W4063 HWY NN, ELKHORN, WI 53121-4338
(262) 741-1440
(262) 743-2221
Mailing address
323 S LOWER GARDENS RD, FONTANA, WI 53125-1102
(262) 903-0784

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11373-123
WI

Other

Enumeration date
09/03/2024
Last updated
07/03/2025
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