Provider Demographics
NPI:1538692140
Name:SOCKER, RENEE (MASTERS OF EDUCATION)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:SOCKER
Suffix:
Gender:F
Credentials:MASTERS OF EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039 W MASON ST
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-1842
Mailing Address - Country:US
Mailing Address - Phone:920-965-7707
Mailing Address - Fax:888-496-6227
Practice Address - Street 1:1039 W MASON ST
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-1842
Practice Address - Country:US
Practice Address - Phone:920-965-7707
Practice Address - Fax:888-496-6227
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health