Individual
DALE S RASMUSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSW CSAC
Contact information
Practice address
2640 W POINT RD, GREEN BAY, WI 54304-1344
(920) 869-2711
Mailing address
PO BOX 365, ONEIDA, WI 54155-0365
(920) 869-2711
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10679-132
WI
1041C0700X
Clinical Social Worker
1308-120
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39168800
—
WI
Enumeration date
10/28/2005
Last updated
05/13/2020
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