Individual
MELISSA S MARQUART-CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1501 CREEKSIDE LN, GREEN BAY, WI 54311-7351
(920) 288-8030
Mailing address
1501 CREEKSIDE LN, GREEN BAY, WI 54311-7351
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
2560
WI
103T00000X
Psychologist
Primary
2560
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39149700
—
WI
01
—
P00460245
RAILROAD
WI
Enumeration date
06/29/2006
Last updated
05/14/2024
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