Individual
LACEY DEITELHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1375 E MAIN ST, REEDSBURG, WI 53959-1498
(608) 415-4449
(608) 415-4469
Mailing address
1375 E MAIN ST, REEDSBURG, WI 53959-1498
(608) 415-4449
(608) 415-4469
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
WI
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100082081
—
WI
Enumeration date
09/16/2024
Last updated
04/21/2026
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