Organization
IMPACT MENTAL HEALTH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HALLIE M BARBARA LPC (PRESIDENT)
(507) 696-4034
Entity
Organization
Contact information
Practice address
2300 RIVERSIDE DR, GREEN BAY, WI 54301-1900
(507) 696-4034
Mailing address
2250 MEADOW RIDGE DR, DE PERE, WI 54115-7200
(507) 696-4034
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/21/2022
Last updated
07/21/2022
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