Individual
JENNIFER D. DEGROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
548 NICOLE LN, WRIGHTSTOWN, WI 54180-1219
(920) 517-0906
Mailing address
548 NICOLE LN, WRIGHTSTOWN, WI 54180-1219
(920) 517-0906
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4348-125
WI
104100000X
Social Worker
5568-120
WI
Other
Enumeration date
12/31/2012
Last updated
12/31/2012
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