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Individual

MR. DAVID MCCLARY PAUL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
9792 HWY 70 WEST, MINOCQUA, WI 54548-1390
(715) 356-1793
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
7833
WI
104100000X
Social Worker
IA 850
IA
1041C0700X
Clinical Social Worker
Primary
7833
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1942309828
WI
Enumeration date
09/21/2006
Last updated
03/01/2012
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