Individual
PAIGE M DORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, APSW
Contact information
Practice address
626 S IRWIN AVE, GREEN BAY, WI 54301
(920) 436-6800
(920) 432-5966
Mailing address
P.O. BOX 22308, GREEN BAY, WI 54305-2308
(920) 436-6800
(920) 432-5966
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
130905
WI
1041C0700X
Clinical Social Worker
Primary
9443
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053881607
—
WI
Enumeration date
11/27/2018
Last updated
06/23/2020
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