Provider Demographics
NPI:1952487183
Name:MEIER, MARY (BSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:MEIER
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:SPONHOLZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:PO BOX 22308
Mailing Address - Street 2:300 CROOKS STREET
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2308
Mailing Address - Country:US
Mailing Address - Phone:920-436-6800
Mailing Address - Fax:920-432-5966
Practice Address - Street 1:300 CROOKS STREET
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54305-2308
Practice Address - Country:US
Practice Address - Phone:920-436-6800
Practice Address - Fax:920-432-5966
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator