Provider Demographics
NPI:1346467834
Name:CHRISTENSEN, DEANNA LYNN (MSSW1203)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:LYNN
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:MSSW1203
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424A E LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-2145
Mailing Address - Country:US
Mailing Address - Phone:920-882-9877
Mailing Address - Fax:920-882-9880
Practice Address - Street 1:424A E LONGVIEW DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-2145
Practice Address - Country:US
Practice Address - Phone:920-882-9877
Practice Address - Fax:920-882-9880
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3438-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical