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General NPI Number Information
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NPI Number | 1578620761
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Entity Type | Individual
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Provider Name | JOHN R BRIGGS PHD
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Gender | Male
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 12/05/2022
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Provider Practice Location Address
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Address Line | 1095 MIDWAY RD
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City | MENASHA
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State | WI
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Zip | 54952-1115
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Country | US
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Telephone | 920-720-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 3 NEENAH CTR
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City | NEENAH
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State | WI
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Zip | 54956-3070
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Country | US
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Telephone | 920-720-2300
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Fax | 920-720-3719
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 1983-057
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License Number State | WI
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