| Blue Waters Family Counseling, S.c. | |
|
2215 Washington St Manitowoc WI 54220-4847 | |
| (920) 683-3911 | |
| (920) 683-3411 |
| Full Name | Blue Waters Family Counseling, S.c. |
|---|---|
| Speciality | Counselor |
| Location | 2215 Washington St, Manitowoc, Wisconsin |
| Authorized Official Name and Position | Diane M Berry (DIRECTOR) |
| Authorized Official Contact | 9206833911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Waters Family Counseling, S.c. 2215 Washington St Manitowoc WI 54220-4847 Ph: (920) 683-3911 | Blue Waters Family Counseling, S.c. 2215 Washington St Manitowoc WI 54220-4847 Ph: (920) 683-3911 |
| NPI Number | 1366556359 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 02/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366556359 | NPI | - | NPPES |
| 42217300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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