Provider Demographics
NPI:1851461099
Name:KREEB, JENNIFER BETH (TLPC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:BETH
Last Name:KREEB
Suffix:
Gender:F
Credentials:TLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S103W24935 COUNTY ROAD L
Mailing Address - Street 2:
Mailing Address - City:MUKWONAGO
Mailing Address - State:WI
Mailing Address - Zip Code:53149-9169
Mailing Address - Country:US
Mailing Address - Phone:262-662-0690
Mailing Address - Fax:262-367-5629
Practice Address - Street 1:155 E CAPITOL DR
Practice Address - Street 2:SUITE # 1
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-2134
Practice Address - Country:US
Practice Address - Phone:262-367-5501
Practice Address - Fax:262-367-5629
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional