Individual
LYDIA JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
123 N OAKLAND AVE, GREEN BAY, WI 54303-2831
(920) 770-4088
(920) 432-5966
Mailing address
123 N OAKLAND AVE, GREEN BAY, WI 54303-2831
(920) 770-4088
(651) 705-0026
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8327
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100086090
—
WI
Enumeration date
02/26/2019
Last updated
03/09/2022
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