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Individual

MR. CARL T. VITENSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APSW

Contact information

Practice address
8901 W CAPITOL DR, MILWAUKEE, WI 53222-1706
(414) 465-1360
Mailing address
1505 N 60TH ST, MILWAUKEE, WI 53208-2153
(414) 526-0982

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
127873-121
WI

Other

Enumeration date
06/10/2011
Last updated
06/10/2011
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