Most Relevant Information
Provider Data
| NPI Number: | 1003576927 |
| Provider Name: | CARISA MARIE DIMATTINA LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 9609-123 |
Most Important Dates
| Enumeration Date: | 12/20/2021 |
| Last Updated: | 12/20/2021 |
Provider Practice Location
9000 W WISCONSIN AVE
MILWAUKEE
WI
532264874
Practice Location Phone/Fax
| Phone: | 4145814004 |
| Fax: |
Provider Mailing Location
9000 W WISCONSIN AVE
MILWAUKEE
WI
532264874
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |