Organization
EMBODIED-WELLLBEING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH PAUL NEILITZ LPC (CLINICAL THERAPIST)
(920) 521-8940
Entity
Organization
Contact information
Practice address
2501 JENNY LANE, GREEN BAY, WI 54302
(920) 212-7523
Mailing address
2501 JENNY LN APT 8, GREEN BAY, WI 54302-5039
(920) 521-8940
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
12/22/2022
Last updated
11/03/2023
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