Individual provider · Type 1 NPI

Debra Marie Dominczak, LPC IT

Mental Health Counselor · Menasha, WI

NPI number 1821337601 Active

Practice location

1478 Kenwood Dr Ste 1
Menasha, WI 54952-1161

Call (920) 886-9319 Map

Fax (920) 886-9357

Mailing address

N6781 Harrison Rd
Hilbert, WI 54129-9262

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X1440-226 (WI)

Mental Health Counselor: Definition to come...

10 other providers at this address

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About NPI 1821337601

Debra Marie Dominczak, LPC IT's National Provider Identifier is 1821337601, issued on Feb 13, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Menasha, WI. The record was last updated on Feb 13, 2013.