Most Relevant Information
Provider Data
| NPI Number: | 1003484478 |
| Provider Name: | JOHN BARAJAS LPC-IT, SAC-IT |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 4984-226 |
Most Important Dates
| Enumeration Date: | 06/14/2021 |
| Last Updated: | 06/14/2021 |
Provider Practice Location
424 S MONROE AVE STE 201
GREEN BAY
WI
543014054
Practice Location Phone/Fax
| Phone: | 9204450170 |
| Fax: | 9204450174 |
Provider Mailing Location
424 S MONROE AVE STE 201
GREEN BAY
WI
543014054
Provider Mailing Phone/Fax
| Phone: | 9204450170 |
| Fax: |