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1740326370
PAUL MICHAEL DEFAZIO
KENOSHA, WI
NPI
1740326370
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: WI 3123123)
Enumeration Date
2007-01-30
Last Update Date
2007-07-08
Business Address
Mr. PAUL MICHAEL DEFAZIO MSW
3734 7TH AVENUE SUITE 24
KENOSHA, WI 53140
Phone number: 262-654-0487
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Mailing Address
Mr. PAUL MICHAEL DEFAZIO MSW
3734 7TH AVENUE SUITE 24
KENOSHA, WI 53140
Phone number: 262-654-0487
Copy
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