Individual
MICHAEL DILLENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, CADC III
Contact information
Practice address
4325 S 60TH ST, GREENFIELD, WI 53220-3508
(414) 546-0467
(414) 546-0678
Mailing address
285 N JANACEK RD, BROOKFIELD, WI 53045-6102
(262) 641-9050
(262) 641-9126
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
591
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43558400
—
WI
Enumeration date
07/25/2006
Last updated
01/02/2008
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