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General NPI Number Information
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NPI Number | 1255709747
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Entity Type | Individual
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Provider Name | VIVIAN SWEETHEART BISHOP-COOK
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Gender | Female
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Dates
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Enumeration Date | 09/14/2015
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Last Update Date | 09/14/2015
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Provider Practice Location Address
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Address Line | 2920 SOUTH WEBSTER AVE
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City | GREEN BAY
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State | WI
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Zip | 54301
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Country | US
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Telephone | 920-632-4471
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Fax | 920-632-4315
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Provider Business Mailing Address
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Address Line | 625 KNOLL TER
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City | DE PERE
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State | WI
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Zip | 54115-3321
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Country | US
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Telephone | 920-713-4632
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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