| Family Services Of Northeast Wi, Inc | |
|
3430 Spirit Way Green Bay WI 54304-5687 | |
| (920) 330-0339 | |
| Not Available |
| Full Name | Family Services Of Northeast Wi, Inc |
|---|---|
| Speciality | Counselor |
| Location | 3430 Spirit Way, Green Bay, Wisconsin |
| Authorized Official Name and Position | Katherine K Jensen (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 9203300339 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Services Of Northeast Wi, Inc 3430 Spirit Way Green Bay WI 54304-5687 Ph: (920) 330-0339 | Family Services Of Northeast Wi, Inc 3430 Spirit Way Green Bay WI 54304-5687 Ph: (920) 330-0339 |
| NPI Number | 1679769343 |
|---|---|
| Provider Enumeration Date | 09/17/2007 |
| Last Update Date | 09/17/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679769343 | NPI | - | NPPES |
| 43713200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 3851-125 (Wisconsin) | Primary |
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