| New Changes Llc | |
|
3311 S Packerland Dr Suite A #19 De Pere WI 54115-9539 | |
| (920) 530-4433 | |
| (920) 688-4261 |
| Full Name | New Changes Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3311 S Packerland Dr, De Pere, Wisconsin |
| Authorized Official Name and Position | Bobbie Jo Lee Bleser (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 9205304433 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Changes Llc 3311 S Packerland Dr Suite A #19 De Pere WI 54115-9539 Ph: (920) 530-4433 | New Changes Llc 3311 S Packerland Dr Suite A #19 De Pere WI 54115-9539 Ph: (920) 530-4433 |
| NPI Number | 1730928532 |
|---|---|
| Provider Enumeration Date | 05/21/2024 |
| Last Update Date | 05/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730928532 | NPI | - | NPPES |
| 10021415 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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