Individual
MICHAEL DEBRUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SAC-IT
Contact information
Practice address
201 S GLENRIDGE CT, APPLETON, WI 54914-3905
(414) 552-8427
Mailing address
201 S GLENRIDGE CT, APPLETON, WI 54914-3905
(414) 552-8427
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19245-130
WI
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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