Provider Demographics
NPI:1356699128
Name:VOLL, DENNIS NORMAN (CSW)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:NORMAN
Last Name:VOLL
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 DOMANIK DR
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53404-2910
Mailing Address - Country:US
Mailing Address - Phone:262-676-5833
Mailing Address - Fax:262-633-8900
Practice Address - Street 1:2000 DOMANIK DR
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53404-2910
Practice Address - Country:US
Practice Address - Phone:262-676-5833
Practice Address - Fax:262-633-8900
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4387-120104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker