Individual
ANDREW DEVERA RONQUILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6980 N PORT WASHINGTON RD, MILWAUKEE, WI 53217-3900
(414) 351-7100
(414) 247-4082
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16286-130
WI
101YP2500X
Professional Counselor
Primary
5489
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100033352
—
WI
Enumeration date
03/28/2012
Last updated
10/07/2025
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