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General NPI Number Information
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NPI Number | 1629863717
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Entity Type | Individual
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Provider Name | MCKAYLA MARIE DREW APSW
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Gender | Female
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Dates
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Enumeration Date | 04/10/2025
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 611 SHERMAN AVE E
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City | FORT ATKINSON
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State | WI
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Zip | 53538-1960
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Country | US
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Telephone | 920-568-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 74 HARVEST DR APT 7301
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City | FOND DU LAC
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State | WI
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Zip | 54937-2324
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Country | US
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Telephone | 920-517-1829
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 135385121
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License Number State | WI
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