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Organization

JACOBS WELL PRESBYTERIAN CHURCHA

Active
Other names
Jacobs Well Church Counseling
Organization subpart
No

Provider details

NPI number
Authorized official
SPENCER REA HANSEN THOMAS LPC (PASTOR OF CARE AND COUNSELING)
(309) 532-2364
Entity
Organization

Contact information

Practice address
3340 LINEVILLE RD, GREEN BAY, WI 54313-7237
(920) 264-9564
Mailing address
3340 LINEVILLE RD, GREEN BAY, WI 54313-7237
(920) 264-9564

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
05/11/2021
Last updated
05/11/2021
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