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Individual

JENNIFER DELFOSSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
220 WASHINGTON AVE, OSHKOSH, WI 54901-5030
(920) 236-4728
(920) 236-1157
Mailing address
220 WASHINGTON AVE, OSHKOSH, WI 54901-5030
(920) 236-4728
(920) 236-1157

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15702-131
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42139300
WI
Enumeration date
07/30/2014
Last updated
07/30/2014
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