Individual
MRS. HEIDI L DESTREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1499 6TH ST, GREEN BAY, WI 54304-2252
(920) 497-6161
(920) 498-0476
Mailing address
1499 6TH ST, GREEN BAY, WI 54304-2252
(920) 497-6161
(920) 498-0476
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/18/2010
Last updated
05/18/2010
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