Provider Demographics
NPI:1487265906
Name:GEIS, ABIGAIL (MS ED)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:GEIS
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17
Mailing Address - Street 2:
Mailing Address - City:NEW LISBON
Mailing Address - State:WI
Mailing Address - Zip Code:53950-0017
Mailing Address - Country:US
Mailing Address - Phone:608-562-3976
Mailing Address - Fax:
Practice Address - Street 1:121 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:NEW LISBON
Practice Address - State:WI
Practice Address - Zip Code:53950-1205
Practice Address - Country:US
Practice Address - Phone:608-562-3976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool