Individual
JACLYN NINA GEITNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
424 E LONGVIEW DR STE A, APPLETON, WI 54911
(920) 234-9240
(920) 335-0014
Mailing address
424 E LONGVIEW DR STE A, APPLETON, WI 54911-2167
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8509-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100033143
—
WI
Enumeration date
10/06/2011
Last updated
09/12/2019
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