Individual
MR. DENNIS KEITH WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
12065 W JANESVILLE ROAD, HALES CORNERS, WI 53130
(414) 425-2655
Mailing address
19090 STILL POINT TRAIL, BROOKFIELD, WI 53045
(262) 786-0912
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2698123LCSW
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2698123
STATE OF WIS DEPT OF REGU
WI
05
—
39534600
—
WI
Enumeration date
01/09/2007
Last updated
07/08/2007
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