Elmergreen, Kandace J
Elmergreen, Kandace J is an individual health care provider with primary practice located at 114 Grand Ave , Wausau WI 54403-6214. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Elmergreen, Kandace J can be contacted via phone (715) 845-7175.Contact Information
Primary practice address
114 Grand Ave
Wausau WI 54403-6214
Phone: (715) 845-7175
Fax: (715) 845-7142
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2442-123 | Wisconsin |
Profile Details
| NPI number | 1497874291 |
|---|---|
| LBN Legal business name | Elmergreen, Kandace J |
| Credentials | MS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 29th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497874291 | NPPES |
| Wisconsin | MEDICAID | 43561100 |
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