Individual
MOLLY ANNE GRETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
74 S MAIN ST STE 103, FOND DU LAC, WI 54935-4274
(920) 210-1059
Mailing address
74 S MAIN ST STE 103, FOND DU LAC, WI 54935-4274
(920) 210-1059
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8351
WI
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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