Individual
RENEE L SOROKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
230 PARK ST, WAUTOMA, WI 54982-9031
(920) 787-6550
(920) 787-0461
Mailing address
PO BOX 1230, WAUTOMA, WI 54982-1230
(920) 787-6550
(920) 787-0461
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
104100000X
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40907300
—
WI
Enumeration date
04/01/2008
Last updated
06/18/2015
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