Individual
REBECCA L GREEN BLANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, APSW
Contact information
Practice address
2640 WEST POINT ROAD, GREEN BAY, WI 54304-1344
(920) 490-3762
Mailing address
PO BOX 365, ONEIDA, WI 54155-0365
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
131058-121
WI
Other
Enumeration date
05/15/2020
Last updated
05/15/2020
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