| Agnesian Beyond Boundaries Of Autism | |
|
40 Camelot Dr Fond Du Lac WI 54935-8049 | |
| (920) 907-8201 | |
| Not Available |
| Full Name | Agnesian Beyond Boundaries Of Autism |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 40 Camelot Dr, Fond Du Lac, Wisconsin |
| Authorized Official Name and Position | Bonnie R Schmitz (VP & CFO) |
| Authorized Official Contact | 9209264480 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Agnesian Beyond Boundaries Of Autism 40 Camelot Dr Fond Du Lac WI 54935-8049 Ph: (920) 907-8201 | Agnesian Beyond Boundaries Of Autism 40 Camelot Dr Fond Du Lac WI 54935-8049 Ph: (920) 907-8201 |
| NPI Number | 1760902191 |
|---|---|
| Provider Enumeration Date | 06/27/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760902191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 2226 (Wisconsin) | Primary |
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