Provider Demographics
NPI:1982948873
Name:TOLTZMAN KNAPP, CHRISTINE (LPC, NCC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:TOLTZMAN KNAPP
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 SUPERIOR RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-7595
Mailing Address - Country:US
Mailing Address - Phone:920-393-4148
Mailing Address - Fax:920-393-4244
Practice Address - Street 1:715 SUPERIOR RD
Practice Address - Street 2:SUITE 101
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-7594
Practice Address - Country:US
Practice Address - Phone:920-393-4148
Practice Address - Fax:920-393-4244
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4380-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional