Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 126814-121 | WI |
NPI | 1003435249 |
---|---|
Provider Name | Margaret Anne Nealon |
First Address | Wauwatosa, WI 53226-3107 |
Second Address | Wauwatosa, WI 53226-3107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2020 |
Last Update Date | 08/04/2020 |