Healthcare Provider Details

I. General information

NPI: 1942546171
Provider Name (Legal Business Name): GEORGEANN MARIE KNIER APSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2012
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E WALDO BLVD
MANITOWOC WI
54220-2912
US

IV. Provider business mailing address

615 S 8TH ST STE 210
SHEBOYGAN WI
53081-4468
US

V. Phone/Fax

Practice location:
  • Phone: 920-323-7742
  • Fax:
Mailing address:
  • Phone: 920-629-4704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: