Individual
MRS. JILL RENEE WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
102 GRAND SEASONS DR, WAUPACA, WI 54981-8298
(715) 256-3419
(715) 258-2994
Mailing address
102 GRAND SEASONS DR, WAUPACA, WI 54981-8298
(715) 256-3419
(715) 258-2994
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10975120
WI
Other
Enumeration date
08/10/2012
Last updated
08/21/2012
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