Bohatkiewicz, Marilyn Elizabeth

Bohatkiewicz, Marilyn Elizabeth is an sole proprietor health care provider with primary practice located at 2200 Dickinson Rd Unit 4 Suite B, De Pere WI 54115-4056. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bohatkiewicz, Marilyn Elizabeth can be contacted via phone (920) 347-3500.

Contact Information

Primary practice address
2200 Dickinson Rd Unit 4 Suite B De Pere WI 54115-4056
Phone: (920) 347-3500
Fax: (920) 347-3501
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1180057 Wisconsin

Profile Details

NPI number 1992884159
LBN Legal business name Bohatkiewicz, Marilyn Elizabeth
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 6th, 2006
Last updated Feb 24th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992884159 NPPES
Wisconsin MEDICAID 39040500

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