Individual
ANGELA ERTL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
4615
ND
1041C0700X
Clinical Social Worker
Primary
8508-123
WI
Other
Enumeration date
05/16/2014
Last updated
05/11/2016
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