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Individual

SHERYL L GORA-BOLLOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
1910 SOUTH AVE, LA CROSSE, WI 54601-5467
(608) 775-2287
Mailing address
1910 SOUTH AVE, LA CROSSE, WI 54601-5467
(608) 775-2287

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4303
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39718600
WI
Enumeration date
06/21/2005
Last updated
10/17/2007
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