Provider Information for 1578125704
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ELIZABETH MALCHOW MSW, APSW
Sex: Female
NPI: 1578125704
Last Updated: 2019-07-09
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1578125704 | ||||||||||||
| Enumeration Date | 2019-07-09 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | P.O. BOX 280 KESHENA, WI 54135-0280 United States Phone: 715-799-3861 | Fax:715-799-3517 | ||||||||||||
| Primary Practice Address | W3272 WOLF RIVER DRIVE KESHENA, WI 54135-9202 United States Phone: 715-799-3861 | Fax:715-799-3517 | ||||||||||||
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