Most Relevant Information
Provider Data
| NPI Number: | 1003396631 |
| Provider Name: | CARLY R TEBO LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 131124-121 |
Most Important Dates
| Enumeration Date: | 08/14/2018 |
| Last Updated: | 05/11/2021 |
Provider Practice Location
7818 MOLINE RD
WEBSTER
WI
548938545
Practice Location Phone/Fax
| Phone: | 7158668301 |
| Fax: | 7158668374 |
Provider Mailing Location
PO BOX 309
SIREN
WI
548720309
Provider Mailing Phone/Fax
| Phone: | 7153497069 |
| Fax: | 8886258634 |