| Embodied-wellbeing Limited Liability Company | |
|
2701 Larsen Rd # Ba109 Green Bay WI 54303-4863 | |
| (920) 521-8940 | |
| Not Available |
| Full Name | Embodied-wellbeing Limited Liability Company |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2701 Larsen Rd # Ba109, Green Bay, Wisconsin |
| Authorized Official Name and Position | Keith Paul Neilitz (CLINICAL THERAPIST) |
| Authorized Official Contact | 9205218940 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Embodied-wellbeing Limited Liability Company 2701 Larsen Rd # Ba109 Green Bay WI 54303-4863 Ph: (920) 521-8940 | Embodied-wellbeing Limited Liability Company 2701 Larsen Rd # Ba109 Green Bay WI 54303-4863 Ph: (920) 521-8940 |
| NPI Number | 1851003826 |
|---|---|
| Provider Enumeration Date | 12/21/2022 |
| Last Update Date | 05/27/2023 |
| Certification Date | 05/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851003826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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