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Individual

TOM A DEFRANCESCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW, CADC

Contact information

Practice address
4810 NORTHWESTERN AVE, RACINE, WI 53406-1504
(262) 637-9984
(262) 637-9995
Mailing address
4810 NORTHWESTERN AVE, RACINE, WI 53406-1504
(262) 637-9984
(262) 637-9995

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11971
WI
1041C0700X
Clinical Social Worker
Primary
1166-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39549500
WI
Enumeration date
02/13/2007
Last updated
09/23/2010
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