Individual
DEANNA L MAULSON-GRESKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
533 PEACE PIPE RD, LAC DU FLAMBEAU, WI 54538-0189
(715) 588-1511
(715) 588-3903
Mailing address
PO BOX 189, LAC DU FLAMBEAU, WI 54538-0189
(715) 588-1511
(715) 588-3903
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18970-130
WI
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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