Garbaciak, Justine Marie
Garbaciak, Justine Marie is an individual health care provider with primary practice located at 301 N Broadway Ste 110 , De Pere WI 54115-2571. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Garbaciak, Justine Marie can be contacted via phone (920) 370-7167.Contact Information
Primary practice address
301 N Broadway Ste 110
De Pere WI 54115-2571
Phone: (920) 370-7167
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 3839 | Wisconsin |
Profile Details
| NPI number | 1235294612 |
|---|---|
| LBN Legal business name | Garbaciak, Justine Marie |
| Credentials | M.S. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 26th, 2006 |
| Last updated | Nov 12th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235294612 | NPPES |
| Wisconsin | MEDICAID | 43710000 |
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