Individual
LORI M. DOLLEVOET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LPC, SAP
Contact information
Practice address
47 PARK PL, SUITE 200, APPLETON, WI 54914-8276
(920) 339-2000
Mailing address
E7911 PUURI RD, FREMONT, WI 54940-9755
(920) 667-5215
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC 342-125
WI
1041C0700X
Clinical Social Worker
Primary
LCSW 1985-123
WI
Other
Enumeration date
09/28/2009
Last updated
09/28/2009
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