is a Clinical in Milwaukee, Wisconsin. practices all healthcare services and medical treatments related to Clinical. The NPI Number for is 1780894600. The last update date is .
's current location address is 1729 N Hubbard St, Milwaukee, Wisconsin. You can contact this provider via phone number 4146403700. The mailing address for is 1729 N Hubbard St, Milwaukee, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1729 N Hubbard St, Milwaukee, Wisconsin |
| Phone Number | 4146403700 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1780894600 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1729 N Hubbard St |
|---|---|
| City | Milwaukee |
| State | Wisconsin (WI) |
| Post Code | 532123964 |
| Phone Number | 4146403700 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 1018 |
|
Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| STATE LICENSE | WI | 1018 |
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