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Individual

MRS. JEAN BLAIR MEYER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC-IT

Contact information

Practice address
115 N CENTER ST, BEAVER DAM, WI 53916-2119
(920) 887-1766
Mailing address
212 W 3RD ST, BEAVER DAM, WI 53916-1616
(920) 296-7616

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2566226
WI

Other

Enumeration date
01/19/2016
Last updated
01/19/2016
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