Ms. Ellen C. Pederson-lewis LCSW
Full Name
Ms. Ellen Claire Pederson-lewis LCSW
NPI Number
1649306317
NPI Type
Individual Provider
Gender
Female
Enumeration Date
02/26/2007
Specialties
(Taxonomies)Licenses
State
Wisconsin
Wisconsin
License Number
1679-123
401-124
Contact
Information
Purpose
Mailing
Location
Address
7717 N BOYD WAY
675 N BROOKFIELD RD
City
Fox Point
Brookfield
State
WI
WI
Postal Code
53217-3210
53045-5858
Country
US
US
Telephone Number
(414) 690-2197
(262) 641-9300
Identifiers
Identifier
39296900
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