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General NPI Number Information
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NPI Number | 1548989411
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Entity Type | Individual
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Provider Name | AUSTANN DIXIE JEAN ABBOTT CSW
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Gender | Female
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Dates
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Enumeration Date | 08/24/2022
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 1021 N SUPERIOR AVE STE 10
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City | TOMAH
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State | WI
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Zip | 54660-1192
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Country | US
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Telephone | 608-886-9023
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Fax | 608-200-2417
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Provider Business Mailing Address
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Address Line | PO BOX 92
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City | MCFARLAND
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State | WI
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Zip | 53558-0092
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Country | US
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Telephone | 608-301-5376
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Fax | 608-200-2417
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 12992-120
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License Number State | WI
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