Individual
WALTER DREW BRANDLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-4200
(920) 926-8885
Mailing address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-4200
(920) 926-8885
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1063
WI
1041C0700X
Clinical Social Worker
1063
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12840
DEAN HEALTH
WI
05
—
39619800
—
WI
Enumeration date
09/14/2006
Last updated
08/03/2022
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