Individual
BRENDA J MALCOREQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
300 CROOKS ST, GREEN BAY, WI 54301-4527
(920) 436-6800
(920) 432-5966
Mailing address
PO BOX 22308, GREEN BAY, WI 54305-2308
(920) 436-6800
(920) 432-5966
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/15/2016
Last updated
09/15/2016
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