Individual
MRS. MARY BETH PROELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
N59W24495 QUAIL RUN LN, SUSSEX, WI 53089-3682
(414) 416-7310
Mailing address
N59W24495 QUAIL RUN LN, SUSSEX, WI 53089-3682
(414) 416-7310
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2656-123
WI
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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