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Individual

MR. TERRANCE S MAPES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
3860 MONROE RD, DE PERE, WI 54115
(920) 272-1200
(920) 272-1201
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 272-1200
(920) 272-1201

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2880-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39675600
WI
Enumeration date
08/13/2006
Last updated
12/16/2020
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