Individual
JEFFERY JON STUMBRAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
2680 VERNON DR, GREEN BAY, WI 54304-5374
(920) 496-4700
(920) 496-4705
Mailing address
2680 VERNON DR, GREEN BAY, WI 54304-5374
(920) 496-4700
(920) 496-4705
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2296
WI
106H00000X
Marriage & Family Therapist
248
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39578400
—
WI
Enumeration date
07/25/2006
Last updated
01/06/2012
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