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Organization

MARRIAGE & FAMILY THERAPY CENTER

Active
Other names
Gerald J Wellens PhD
Organization subpart
No

Provider details

NPI number
Authorized official
MOLLY ROSE CREVIER (OFFICE ADMIN)
(920) 432-8777
Entity
Organization

Contact information

Practice address
735 E WALNUT ST, GREEN BAY, WI 54301
(920) 432-8777
(920) 435-0749
Mailing address
735 E WALNUT ST, GREEN BAY, WI 54301
(920) 432-8777
(920) 435-0749

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42148600
WI
Enumeration date
03/04/2008
Last updated
03/04/2008
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