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Individual

ANGELA DELLISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, CSAC, CS-IT

Contact information

Practice address
6233 DURAND AVE, MOUNT PLEASANT, WI 53406-4961
(262) 554-8165
Mailing address
3900 W BROWN DEER RD, SUITE 200, BROWN DEER, WI 53209-1220
(414) 540-2170

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16057-130
WI
101YP2500X
Professional Counselor
Primary
5385-125
WI

Other

Enumeration date
06/28/2011
Last updated
08/26/2014
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