Provider Demographics
NPI:1619987831
Name:CAMERON, ELIZABETH S (APSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:S
Last Name:CAMERON
Suffix:
Gender:F
Credentials:APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6325 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:MERRILL
Mailing Address - State:WI
Mailing Address - Zip Code:54452-7704
Mailing Address - Country:US
Mailing Address - Phone:715-848-3031
Mailing Address - Fax:715-848-5008
Practice Address - Street 1:614 N 3RD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-2913
Practice Address - Country:US
Practice Address - Phone:715-848-3031
Practice Address - Fax:715-848-5008
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI575-121104100000X
WI56649-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered163W00000XNursing Service ProvidersRegistered Nurse