Organization

Shelley Boehm Mattia Md,adult Psychiatry, Llc

Adult Mental Health Clinic/Center in Green Bay, WI(View on Map)

Legal Business Name

Shelley Boehm Mattia Md,adult Psychiatry, Llc

NPI Number

1427410992

NPI Type

Organization

Enumeration Date

03/24/2016

Specialties

(Taxonomies)

Code

261QM0850X

Primary Taxonomy

Yes

Licenses

State

Wisconsin

License Number

39641

Contact
Information

Purpose

Mailing
Location

Address

428 DOTY ST
428 DOTY ST

City

Green Bay
Green Bay

State

WI
WI

Postal Code

54301-4509
54301-4509

Country

US
US

Telephone Number

(920) 965-6768
(920) 965-6768

Authorized Official

Name

Dr. Shelley Boehm Mattia

Title or Position

LICENSED PHYSICIAN

Telephone Number

(920) 246-4925

Identifiers

Identifier

32453500

Identifier State

WI

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/04/2016

Provider Address

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