Bridgeport Counseling | |
2231 Catlin Ave Room #310 Superior WI 54880-5137 | |
(715) 395-7825 | |
(715) 395-7826 |
Full Name | Bridgeport Counseling |
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Speciality | Counselor - Professional |
Location | 2231 Catlin Ave, Superior, Wisconsin |
Authorized Official Name and Position | Timothy Lloyd Panula (LICENSED PROFESSIONAL COUNSELOR) |
Authorized Official Contact | 7153957825 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Bridgeport Counseling 2231 Catlin Ave Room #310 Superior WI 54880-5137 Ph: (715) 395-7825 | Bridgeport Counseling 2231 Catlin Ave Room #310 Superior WI 54880-5137 Ph: (715) 395-7825 |
NPI Number | 1427208784 |
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Provider Enumeration Date | 09/23/2008 |
Last Update Date | 09/23/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427208784 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 2837-125 (Wisconsin) | Primary |
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