Lace, John Walter

Lace, John Walter is an individual health care provider with primary practice located at 1821 S Webster Ave , Green Bay WI 54301-2253. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is his primary health care specialty. Lace, John Walter can be contacted via phone (920) 272-1610.

Contact Information

Primary practice address
1821 S Webster Ave Green Bay WI 54301-2253
Phone: (920) 272-1610
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 110965 Iowa
Behavioral Health & Social Service Providers / Psychologist 103T00000X 5000-57 Wisconsin
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 5000-57 Wisconsin

Profile Details

NPI number 1528705050
LBN Legal business name Lace, John Walter
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2022
Last updated Jan 11th, 2024 - 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.

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