Provider Demographics
NPI:1679603880
Name:JANSSEN, ELIZABETH M (PT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:JANSSEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2918 POST RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-6417
Mailing Address - Country:US
Mailing Address - Phone:715-295-9820
Mailing Address - Fax:715-295-9821
Practice Address - Street 1:2918 POST RD
Practice Address - Street 2:SUITE B
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-6417
Practice Address - Country:US
Practice Address - Phone:715-295-9820
Practice Address - Fax:715-295-9821
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3228024174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist