Organization
CHILDREN'S SERVICE SOCIETY OF WISCONSIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RON PUPP PHD (DIRECTOR OF COUNSELING)
(414) 231-4808
Entity
Organization
Contact information
Practice address
601 S 8TH ST, SHEBOYGAN, WI 53081-4405
(920) 458-5062
(920) 451-3941
Mailing address
601 S 8TH ST, SHEBOYGAN, WI 53081-4405
(920) 458-5062
(920) 451-3941
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42126400
—
WI
Enumeration date
04/14/2008
Last updated
04/14/2008
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