Individual
AMANDA MARIE DEREWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4131 W LOOMIS RD APT 120, GREENFIELD, WI 53221-2006
(414) 424-2445
(414) 424-2446
Mailing address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11512-123
WI
Other
Enumeration date
10/03/2024
Last updated
10/10/2024
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