Individual
KAREN FORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
1300 N JACKSON ST, MILWAUKEE, WI 53202-2602
(414) 390-5800
(414) 225-1340
Mailing address
1300 N JACKSON ST, MILWAUKEE, WI 53202-2602
(414) 390-5800
(414) 225-1340
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7625-123
WI
Other
Enumeration date
04/23/2010
Last updated
04/23/2010
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