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Individual

JILL SANDRA MUNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1442 N FARWELL AVE, MILWAUKEE, WI 53202-2996
(414) 276-3455
(414) 276-3460
Mailing address
3777 S WHITNALL AVE, MILWAUKEE, WI 53207-3931
(414) 769-9428

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4073-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40932500
WI
Enumeration date
04/24/2007
Last updated
07/08/2007
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