Individual
BEVERLY J PAUTZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MSW CAPSW
Contact information
Practice address
300 CROOKS ST, GREEN BAY, WI 54301
(920) 436-6800
(920) 432-5966
Mailing address
300 CROOKS ST, PO BOX 22308, GREEN BAY, WI 54305-2308
(920) 436-6800
(920) 432-5966
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4375
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40930000
—
WI
Enumeration date
02/28/2006
Last updated
07/08/2007
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