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General NPI Number Information
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NPI Number | 1114596921
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Entity Type | Organization
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Legal Business Name | HOLSTEAD CONSULTING SERVICES
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 1050 CIRCLE DR STE B
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City | GREEN BAY
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State | WI
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Zip | 54304-5569
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Country | US
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Telephone | 920-393-7971
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 CIRCLE DR STE B
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City | GREEN BAY
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State | WI
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Zip | 54304-5569
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | JENELL HOLSTEAD
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Credential |
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Telephone | 920-544-2780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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