Radosevich, Deirdre
Radosevich, Deirdre is an sole proprietor health care provider with primary practice located at 5317 W Grande Market Dr Ste F7 , Appleton WI 54913-8465. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Radosevich, Deirdre can be contacted via phone (920) 430-0736.Contact Information
Primary practice address
5317 W Grande Market Dr Ste F7
Appleton WI 54913-8465
Phone: (920) 430-0736
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2992-57 | Wisconsin |
Profile Details
| NPI number | 1851535009 |
|---|---|
| LBN Legal business name | Radosevich, Deirdre |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 30th, 2009 |
| Last updated | Sep 18th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851535009 | NPPES |
| Wisconsin | MEDICAID | 1346622214 |
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