is a Psychologist in Fond Du Lac, Wisconsin. practices all healthcare services and medical treatments related to Psychologist. The NPI Number for is 1861659872. The last update date is .
's current location address is 751 County Road K, Fond Du Lac, Wisconsin. You can contact this provider via phone number 9209296702. The mailing address for is 751 County Road K, Fond Du Lac, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 751 County Road K, Fond Du Lac, Wisconsin |
| Phone Number | 9209296702 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1861659872 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 751 County Road K |
|---|---|
| City | Fond Du Lac |
| State | Wisconsin (WI) |
| Post Code | 549357707 |
| Phone Number | 9209296702 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | 2708-57 |
|
Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 40933200 | WI | -- |
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