Provider Demographics
NPI:1467477877
Name:KASPAR, JUDITH RYAN (MSSW)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:RYAN
Last Name:KASPAR
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:MISS
Other - First Name:JUDITH
Other - Middle Name:ANN
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:199 HOME RD
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:WI
Mailing Address - Zip Code:53039-1401
Mailing Address - Country:US
Mailing Address - Phone:920-386-3500
Mailing Address - Fax:920-386-3812
Practice Address - Street 1:199 HOME RD
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:WI
Practice Address - Zip Code:53039-1401
Practice Address - Country:US
Practice Address - Phone:920-386-3500
Practice Address - Fax:920-386-3812
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical