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Individual
LEE R BEITZEL
Active
Individual
LEE R BEITZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LMFT
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
1020-123
WI
106H00000X
Marriage & Family Therapist
Primary
321-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39558500
—
WI
Enumeration date
07/13/2006
Last updated
01/28/2008
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