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Individual

DEBRA JEAN WENTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW LCSW CADCIII

Contact information

Practice address
2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3129
(920) 457-4461
(920) 459-1483
Mailing address
2801 CALUMET DR, SHEBOYGAN, WI 53083-3839
(920) 457-4461
(920) 459-1483

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1348
WI
1041C0700X
Clinical Social Worker
Primary
6921123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39331400
WI
Enumeration date
09/01/2006
Last updated
03/17/2021
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