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NPI Code Detail

MEDICARE: MR. BRYAN ROBERT JONET LPC

MEDICARE: MR. BRYAN ROBERT JONET LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor3705-125WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710135413
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRYAN ROBERT JONET LPC
Provider Business Mailing Address
First Line : 2339 CEDAR RDG
Second Line : SUTIE 4
City : GREEN BAY
State : WI
Zip : 54313-5700
Country : US
Telephone Number : 920-497-6161
Fax Number : 920-498-0476
Provider Business Practice Location Address
First Line : 2339 CEDAR RDG
Second Line : SUTIE 4
City : GREEN BAY
State : WI
Zip : 54313-5700
Country : US
Telephone Number : 920-497-6161
Fax Number : 920-498-0476
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2008
Last Update Date : 09/05/2008

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