| Northwoods Therapist Llc | |
|
1835 E Edgewood Dr Ste 105-534 Appleton WI 54913-9407 | |
| (715) 889-0784 | |
| Not Available |
| Full Name | Northwoods Therapist Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1835 E Edgewood Dr Ste 105-534, Appleton, Wisconsin |
| Authorized Official Name and Position | Deanna J Brown (OWNER) |
| Authorized Official Contact | 7158890784 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwoods Therapist Llc W7582 Browns Ln Pembine WI 54156-9624 Ph: () - | Northwoods Therapist Llc 1835 E Edgewood Dr Ste 105-534 Appleton WI 54913-9407 Ph: (715) 889-0784 |
| NPI Number | 1427788850 |
|---|---|
| Provider Enumeration Date | 06/17/2022 |
| Last Update Date | 06/17/2022 |
| Certification Date | 06/17/2022 |
| Medicare PECOS PAC ID | 4880067214 |
|---|---|
| Medicare Enrollment ID | O20230305000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427788850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Deanna J Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346265519 PECOS PAC ID: 1052546421 Enrollment ID: I20160608000105 |
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