Jacob P Spangenberg CSAC

NPI 1043510084 - Counselor - 101YA0400X

NPI Details
NPI 1043510084
Gender Male
Enumeration Date 10/25/2010
Last Updated 12/02/2014
Entity Type Individual
Active Over 6 years ago
Practice Location
2979 ALLIED ST
UNIT C
GREEN BAY WI, 54304-5567, US
Phone (920) 337-6740
Fax (920) 337-6741
Business Location
2979 ALLIED ST
UNIT C
GREEN BAY WI, 54304-5567, US
Phone (920) 337-6740
Fax (920) 337-6741
Toxanomy
Taxonomy Code 101YA0400X
License State Wisconsin
License Number 15832-132
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According to our database, Mr. Jacob P Spangenberg CSAC NPI is 1043510084, taxonomy code is 101YA0400X and license number is 15832-132, license state is located at Wisconsin. Jacob P Spangenberg CSAC physically located at 2979 Allied St, Green Bay WI, 54304-5567. NPI Number Jacob P Spangenberg CSAC has the Individual type.

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1043510084 NPI number is provided on an as is basis without warranty of any kind. 1043510084 is maintained by the National Plan & Provider Enumeration System. The contents of Jacob P Spangenberg CSAC are for informational purposes only.