Individual
SPENCER REA HANSEN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3340 LINEVILLE RD, GREEN BAY, WI 54313-7237
(920) 264-9564
Mailing address
3340 LINEVILLE RD, GREEN BAY, WI 54313-7237
(920) 264-9564
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7850-125
WI
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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