Individual
SHADOW JASMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LMT
Contact information
Practice address
251 PROGRESS WAY, WAUNAKEE, WI 53597-2520
(608) 409-3400
Mailing address
1950 FOGGY MOUNTAIN PASS, WAUNAKEE, WI 53597-2383
(608) 409-3400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6526-123
WI
Other
Enumeration date
08/02/2019
Last updated
03/24/2025
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