Brandli, Walter Drew

Brandli, Walter Drew is an individual health care provider with primary practice located at 430 E Division St , Fond Du Lac WI 54935-4560. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Social Worker is his primary health care specialty. Brandli, Walter Drew can be contacted via phone (920) 926-4200.

Contact Information

Primary practice address
430 E Division St Fond Du Lac WI 54935-4560
Phone: (920) 926-4200
Fax: (920) 926-8885
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 1063 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1063 Wisconsin

Profile Details

NPI number 1972608610
LBN Legal business name Brandli, Walter Drew
Credentials MSW, LCSW
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2006
Last updated Aug 3rd, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972608610 NPPES
Wisconsin Other 12840 DEAN HEALTH
Wisconsin MEDICAID 39619800 DEAN HEALTH

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