Ms. Diane R. Carr LCSW
Clinical Social Worker in Brookfield, WI(View on Map)
Full Name
Ms. Diane Rose Carr LCSW
NPI Number
1417051483
NPI Type
Individual Provider
Gender
Female
Enumeration Date
09/12/2006
Specialties
(Taxonomies)Licenses
State
Wisconsin
License Number
1100-123
Contact
Information
Purpose
Mailing
Location
Address
415 LAKE ST
16535 W BLUEMOUND RD
City
Mukwonago
Brookfield
State
WI
WI
Postal Code
53149-1328
53005-5936
Country
US
US
Telephone Number
(262) 363-5152
(262) 789-1191
Identifiers
Identifier
40957700
Identifier State
WI
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/08/2007
Provider Address
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