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Behavioral Health & Social Service Providers Psychologist Adult Development & Aging

Provider NPI: 1528376076

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
Tel: 414-774-1794  Fax: 414-774-1488

Business Mailing Address:
Tel: 414-774-1794  Fax: 414-774-1488

NPI Information:
NPI: 1528376076
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
N103TA0700XBehavioral Health & Social Service Providers
Adult Development & Aging
N103TB0200XBehavioral Health & Social Service Providers
Y103TC0700XBehavioral Health & Social Service Providers
N103TC1900XBehavioral Health & Social Service Providers
N103TC2200XBehavioral Health & Social Service Providers
N103TF0000XBehavioral Health & Social Service Providers
N103TF0200XBehavioral Health & Social Service Providers
N103TP2701XBehavioral Health & Social Service Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 103TC0700X





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