Provider Demographics
NPI:1700621794
Name:HOMANN, KARLI ANNE
Entity type:Individual
Prefix:
First Name:KARLI
Middle Name:ANNE
Last Name:HOMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3531 ANN MARIE DR APT 7
Mailing Address - Street 2:
Mailing Address - City:PLOVER
Mailing Address - State:WI
Mailing Address - Zip Code:54467-4032
Mailing Address - Country:US
Mailing Address - Phone:715-204-8567
Mailing Address - Fax:
Practice Address - Street 1:601 E 3RD ST
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-4512
Practice Address - Country:US
Practice Address - Phone:855-607-8542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health