Individual
MS. MARY JO ADLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSW LCSW
Contact information
Practice address
808 MAIN ST E, MENOMONIE, WI 54751-2735
(715) 232-1116
Mailing address
403 SUMMIT AVE, EAU CLAIRE, WI 54701-4805
(715) 834-9744
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2372-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1029428
PREFERREDONE PIN
WI
01
—
18936
MMSI PROVIDER NUMBER
MN
05
—
39563700
—
WI
01
—
44245
SECURITY HEALTH PLAN ID
WI
Enumeration date
06/05/2006
Last updated
07/09/2007
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