Individual
PATRICIA M. KENOTE-DEPERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
37390 N BRADUM RD, BAYFIELD, WI 54814-4832
(715) 779-3741
(715) 779-3765
Mailing address
88385 PIKE RD, BAYFIELD, WI 54814-4818
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19738
WI
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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