Provider Demographics
NPI:1922287333
Name:BRONSON, RAMONA JEAN (LCSW)
Entity Type:Individual
Prefix:
First Name:RAMONA
Middle Name:JEAN
Last Name:BRONSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RAMONA
Other - Middle Name:JEAN
Other - Last Name:WEITZEL-BRONSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:533 PEACE PIPE RD
Mailing Address - Street 2:
Mailing Address - City:LAC DU FLAMBEAU
Mailing Address - State:WI
Mailing Address - Zip Code:54538-9123
Mailing Address - Country:US
Mailing Address - Phone:715-588-1511
Mailing Address - Fax:175-588-3903
Practice Address - Street 1:533 PEACE PIPE RD
Practice Address - Street 2:
Practice Address - City:LAC DU FLAMBEAU
Practice Address - State:WI
Practice Address - Zip Code:54538-9123
Practice Address - Country:US
Practice Address - Phone:715-588-1511
Practice Address - Fax:175-588-3903
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7911.1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1922287333Medicaid