Provider Demographics
NPI:1679122451
Name:KNETTER, MORGAN ANN MARIE (MSW)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:ANN MARIE
Last Name:KNETTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 WESTON AVE
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WI
Mailing Address - Zip Code:54476-5242
Mailing Address - Country:US
Mailing Address - Phone:715-298-6364
Mailing Address - Fax:715-298-6365
Practice Address - Street 1:718 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SCHOFIELD
Practice Address - State:WI
Practice Address - Zip Code:54476-1086
Practice Address - Country:US
Practice Address - Phone:715-679-3389
Practice Address - Fax:715-679-3612
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty