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General NPI Number Information
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NPI Number | 1689578197
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Entity Type | Organization
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Legal Business Name | REWIRING NEURAL PATHWAYS LLC
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 1620 S LAWE ST STE 1
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City | APPLETON
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State | WI
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Zip | 54915-2419
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Country | US
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Telephone | 920-358-0439
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Fax |
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Provider Business Mailing Address
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Address Line | 1620 S LAWE ST STE 1
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City | APPLETON
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State | WI
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Zip | 54915-2419
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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 | LICENSED PROFESSIONAL COUNSELOR
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Name | STEVEN FRICKE
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Credential |
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Telephone | 920-358-0439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | NULL
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