| Mrs Debra Marie Dominczak, LPC IT | |
|
1478 Kenwood Dr Ste 1, Menasha, WI 54952-1161 | |
| (920) 886-9319 | |
| (920) 886-9357 |
| Full Name | Mrs Debra Marie Dominczak |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 1478 Kenwood Dr Ste 1, Menasha, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821337601 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 1440-226 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Debra Marie Dominczak, LPC IT N6781 Harrison Rd, Hilbert, WI 54129-9262 Ph: (920) 989-2370 | Mrs Debra Marie Dominczak, LPC IT 1478 Kenwood Dr Ste 1, Menasha, WI 54952-1161 Ph: (920) 886-9319 |
Mr. Michael G. Frost, RADCI Counselor Medicare: Medicare Enrolled Practice Location: 1201 Tuckaway Ln, Menasha, WI 54952 Phone: 920-733-4443 Fax: 920-733-4796 | |
Darlene Leary, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1095 Midway Rd, Menasha, WI 54952 Phone: 920-720-2300 | |
Lisa Bredael, Counselor Medicare: Medicare Enrolled Practice Location: 1095 Midway Rd, Menasha, WI 54952 Phone: 920-720-2300 | |
Lynne Drews, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1095 Midway Rd, Menasha, WI 54952 Phone: 920-720-2300 | |
Shauna S Vanden Hoogen, SAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1095 Midway Rd, Menasha, WI 54952 Phone: 920-720-3700 | |
Amber Leigh Greuel, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1095 Midway Rd, Menasha, WI 54952 Phone: 920-720-2300 | |
Sergio Guerrero, LPC-IT Counselor Medicare: Medicare Enrolled Practice Location: 1478 Kenwood Dr Ste 1, Menasha, WI 54952 Phone: 920-886-9319 |