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General NPI Number Information
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NPI Number | 1649088980
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Entity Type | Individual
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Provider Name | STEPHANIE MICHELLE VARILEK
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Gender | Female
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 205 5TH AVE S
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City | LA CROSSE
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State | WI
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Zip | 54601-9202
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Country | US
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Telephone | 608-387-9638
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Fax |
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Provider Business Mailing Address
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Address Line | 3009 NORTH CT APT 104
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City | ONALASKA
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State | WI
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Zip | 54650-6205
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Country | US
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Telephone | 608-931-4478
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 131935-121
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License Number State | WI
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