Individual
BRANDON NITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2102 N 6TH ST, WAUSAU, WI 54403-3438
(208) 403-9508
Mailing address
505 1/2 S WEBB ST, WITTENBERG, WI 54499-9147
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11641-123
WI
Other
Enumeration date
10/24/2023
Last updated
03/12/2024
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