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1659387603
MARK MIXDORF
WAUSAU, WI
NPI
1659387603
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: WI 2541-123)
Enumeration Date
2006-07-31
Last Update Date
2007-07-08
Business Address
MARK MIXDORF ICSW
1100 LAKE VIEW DR
WAUSAU, WI 54403-6785
Phone number: 715-848-4600
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Mailing Address
MARK MIXDORF ICSW
1100 LAKE VIEW DR
WAUSAU, WI 54403-6785
Phone number: 715-848-4600
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