Healthcare Provider Details

I. General information

NPI: 1982948873
Provider Name (Legal Business Name): CHRISTINE TOLTZMAN KNAPP LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2012
Last Update Date: 11/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 SUPERIOR RD SUITE 101
GREEN BAY WI
54311-7594
US

IV. Provider business mailing address

715 SUPERIOR RD SUITE 101
GREEN BAY WI
54311-7595
US

V. Phone/Fax

Practice location:
  • Phone: 920-393-4148
  • Fax: 920-393-4244
Mailing address:
  • Phone: 920-393-4148
  • Fax: 920-393-4244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4380-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: