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Individual

MR. KENNETH G UTECH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
3313 PACKERLAND DR, SUITE D, DE PERE, WI 54115-6810
(920) 983-0707
(920) 983-0700
Mailing address
3313 PACKERLAND DR, SUITE D, DE PERE, WI 54115-6810
(920) 983-0707
(920) 983-0700

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
393-123
WI
106H00000X
Marriage & Family Therapist
Primary
74124
WI

Other

Enumeration date
09/22/2011
Last updated
09/22/2011
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