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General NPI Number Information
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NPI Number | 1780827899
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Entity Type | Individual
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Provider Name | NANCY RADER PERRIN LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/20/2009
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Last Update Date | 04/20/2009
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Provider Practice Location Address
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Address Line | 13700 W NATIONAL AVE
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City | NEW BERLIN
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State | WI
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Zip | 53151-9521
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Country | US
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Telephone | 262-797-7979
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Fax |
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Provider Business Mailing Address
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Address Line | 13650 TULANE ST
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City | BROOKFIELD
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State | WI
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Zip | 53005-7146
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Country | US
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Telephone | 262-782-0652
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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 | 4304-123
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License Number State | WI
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