Most Relevant Information
Provider Data
| NPI Number: | 1003265133 |
| Provider Name: | NATHAN PUTNAM MSW, CAPSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 9024-123 |
Most Important Dates
| Enumeration Date: | 06/09/2016 |
| Last Updated: | 10/03/2018 |
Provider Practice Location
612 N RANDALL AVE
JANESVILLE
WI
535451958
Practice Location Phone/Fax
| Phone: | 6087527660 |
| Fax: | 6087529788 |
Provider Mailing Location
612 N RANDALL AVE
JANESVILLE
WI
535451958
Provider Mailing Phone/Fax
| Phone: | 6087527660 |
| Fax: | 6087529788 |