Individual
DEBRA LYNNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
101 W EDISON AVE STE 215, APPLETON, WI 54915-1390
(920) 410-9036
Mailing address
101 W EDISON AVE STE 215, APPLETON, WI 54915-1390
(920) 410-9036
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6899-123
WI
1041C0700X
Clinical Social Worker
Primary
6899
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41007600
—
WI
Enumeration date
11/29/2006
Last updated
02/06/2021
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