Provider Demographics
NPI:1376703447
Name:FLORSHEIM, NEENA B (PHD)
Entity Type:Individual
Prefix:DR
First Name:NEENA
Middle Name:B
Last Name:FLORSHEIM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10936 N PORT WASHINGTON RD
Mailing Address - Street 2:BOX 264
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-5031
Mailing Address - Country:US
Mailing Address - Phone:414-218-4549
Mailing Address - Fax:262-241-5054
Practice Address - Street 1:1317 W TOWNE SQUARE RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-5017
Practice Address - Country:US
Practice Address - Phone:262-241-5099
Practice Address - Fax:262-241-5054
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1094-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional