Individual
MS. BECKY ANN TWEEDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2517 N VIEW CT, GREEN BAY, WI 54303-6233
(920) 494-5454
(920) 544-9522
Mailing address
2517 N VIEW CT, GREEN BAY, WI 54303-6233
(920) 494-5454
(920) 544-9522
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
171M00000X
—
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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