Doctor Name: | CRAIG LINZMEIER |
NPI Number: | 1003276072 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 4750-125 |
Business Practice Address: | 1511 W Main Ave Suite 100 De Pere, WI - 541159556 |
Business Phone Number: | 9204037600 |
Business Fax Number: | 9204037360 |
Mailing Address: | Po Box 13156, GREEN BAY |
State: | WI |
Postal Code: | 543073156 |
Phone Number: | 9204037600 |
Fax Number: | 9204037360 |
NPI Enumeration Date: | 03/03/2016 |
NPI Last Update Date: | 03/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4750-125 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |