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MS. JULIE A BOBHOLZ PHD
>> Clinical Neuropsychologist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1982659538
Individual Registrant:MS. JULIE A BOBHOLZ PHD
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
2845 GREENBRIER RD STE. 340 GREEN BAY, WI 54311-6519 US
Tel: 920-288-8030 Fax: 920-288-8329
Tel: 920-288-8030 Fax: 920-288-8329
Contact information for business:
164 N BROADWAY GREEN BAY, WI 54303-2728 US
Tel: 920-288-8030 Fax: 920-288-8329
Tel: 920-288-8030 Fax: 920-288-8329
Registration Information:
NPI: 1982659538
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | WI | 2241 |
| N | 103T00000X | Behavioral Health & Social Service Providers Psychologist | WI | 2241 |
| Y | 103TC0700X | Behavioral Health & Social Service Providers Psychologist | WI | 2241 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| HUMANA | 008000315O | 01 | |
| 1982659538 | WI | 05 |
