Doctor Name: | TOM A DEFRANCESCO |
NPI Number: | 1053453381 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW, CADC |
License Number: | 11971 |
Business Practice Address: | 4810 Northwestern Ave Racine, WI - 534061504 |
Business Phone Number: | 2626379984 |
Business Fax Number: | 2626379995 |
Mailing Address: | 4810 Northwestern Ave, RACINE |
State: | WI |
Postal Code: | 534061504 |
Phone Number: | 2626379984 |
Fax Number: | 2626379995 |
NPI Enumeration Date: | 02/13/2007 |
NPI Last Update Date: | 09/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 11971 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |