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2500 Hall Ave Suite B Marinette WI 54143 | |
| (715) 732-7700 | |
| (715) 732-7766 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 2500 Hall Ave, Marinette, Wisconsin |
| Authorized Official Name and Position | Robin Gerald Elsner (HEALTH AND HUMAN SERVICES DIRECTOR) |
| Authorized Official Contact | 7157327700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2500 Hall Ave Suite B Marinette WI 54143 Ph: (715) 732-7700 | 2500 Hall Ave Suite B Marinette WI 54143 Ph: (715) 732-7700 |
| NPI Number | 1508935297 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 09/29/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508935297 | NPI | - | NPPES |
| 32975800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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