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1538880356
LISA RENAE JEFFERSON
TOMAH, WI
NPI
1538880356
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: WI 131995-121)
Enumeration Date
2022-09-09
Last Update Date
2022-09-09
Business Address
LISA RENAE JEFFERSON CAPSW
500 E VETERANS ST
TOMAH, WI 54660-3105
Phone number: 608-372-3971
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Mailing Address
LISA RENAE JEFFERSON CAPSW
961 OAK AVE N
ONALASKA, WI 54650-2196
Phone number: 608-387-5493
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