Individual
JESSICA SIROLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1095 MIDWAY RD, MENASHA, WI 54952-1115
(920) 720-2300
Mailing address
3230 WILLOW PARK DR, DACULA, GA 30019-1361
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MSW005168
GA
1041C0700X
Clinical Social Worker
Primary
9104
WI
Other
Enumeration date
06/25/2013
Last updated
04/09/2021
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