Organization
BAYSHORE COUNSELING NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARI C MARTIN MSE (PSYCHOTHERAPIST)
(920) 469-8890
Entity
Organization
Contact information
Practice address
2345 E MASON ST, GREEN BAY, WI 54302-3764
(920) 469-8890
(920) 406-3909
Mailing address
2345 E MASON ST, GREEN BAY, WI 54302-3764
(920) 469-8890
(920) 406-3909
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
13018-020
WI
251S00000X
Community/Behavioral Health Agency
Primary
1951-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42210300
—
WI
Enumeration date
01/30/2008
Last updated
01/30/2008
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