Individual
DONALD F WILLLSON-BROYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1400 BELLINGER ST, EAU CLAIRE, WI 54703-5222
(715) 838-5222
Mailing address
PO BOX 1510, EAU CLAIRE, WI 54702-1510
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3337
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39190200
—
WI
Enumeration date
05/12/2006
Last updated
05/04/2009
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