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General NPI Number Information
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NPI Number | 1639206857
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Entity Type | Individual
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Provider Name | SARA ELLEN SWITEK LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 333 PINE RIDGE BLVD
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City | WAUSAU
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State | WI
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Zip | 54401-4120
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Country | US
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Telephone | 715-847-2702
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Fax |
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Provider Business Mailing Address
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Address Line | 2402 CRANE DR
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City | WAUSAU
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State | WI
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Zip | 54401-9129
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Country | US
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Telephone | 715-848-0907
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1418-123
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License Number State | WI
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