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Individual

DANIEL R LEQUIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
3150 GERSHWIN DRIVE, GREEN BAY, WI 54311-5859
(920) 391-6940
(920) 391-4811
Mailing address
3150 GERSHWIN DRIVE, GREEN BAY, WI 54311-5859
(920) 391-6940
(920) 391-4811

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3392
WI

Other

Enumeration date
12/05/2006
Last updated
11/10/2009
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