Ms Deanna L Dittloff, | |
1325 Angels Path, De Pere, WI 54115-4050 | |
(920) 338-2855 | |
(920) 338-9270 |
Full Name | Ms Deanna L Dittloff |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 1325 Angels Path, De Pere, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083790240 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 5795-125 (Wisconsin) | Primary |
Entity Name | Bellin Psychiatric Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952554800 PECOS PAC ID: 4486551058 Enrollment ID: O20031212000884 |
Mailing Address | Practice Location Address |
---|---|
Ms Deanna L Dittloff, Po Box 22040, Green Bay, WI 54305-2040 Ph: (920) 445-7222 | Ms Deanna L Dittloff, 1325 Angels Path, De Pere, WI 54115-4050 Ph: (920) 338-2855 |
Craig Linzmeier, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1511 W Main Ave, Suite 100, De Pere, WI 54115 Phone: 920-403-7600 Fax: 920-403-7360 | |
Cassandra Vanstraten, LPC Counselor Medicare: Medicare Enrolled Practice Location: 3860 Monroe Rd, De Pere, WI 54115 Phone: 920-496-4700 | |
Mrs. Carole M St.laurent-groves, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1325 Angels Path Rd, De Pere, WI 54115 Phone: 920-338-2855 Fax: 920-338-9270 | |
Andrew Johnson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 416 George St Ste B12, De Pere, WI 54115 Phone: 920-340-0939 | |
Marie D. Ibarra Stafford, LPC Counselor Medicare: Medicare Enrolled Practice Location: 3860 Monroe Rd, De Pere, WI 54115 Phone: 920-496-4700 | |
Mr. Dan J Braaten, LMFT, SAC Counselor Medicare: Medicare Enrolled Practice Location: 3860 Monroe Rd, De Pere, WI 54115 Phone: 920-496-4700 | |
Stephanie Prevost, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 3860 Monroe Rd, De Pere, WI 54115 Phone: 920-496-4700 |