Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003089236 |
---|---|
Provider Name | Meghann Beth Krueger |
First Address | Madison, WI 53705-2254 |
Second Address | Madison, WI 53705-2254 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2008 |
Last Update Date | 09/04/2008 |