Individual
DANIEL G. DEREZINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS RADCI
Contact information
Practice address
2450 VINEYARD DR, PLOVER, WI 54467-3973
(715) 342-0290
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
(715) 344-8127
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13414
WI
104100000X
Social Worker
3804
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13414
RADC I
WI
Enumeration date
09/16/2006
Last updated
02/14/2024
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