| Childhood Autism Therapies Llc | |
|
N1563 County Road H Palmyra WI 53156-9738 | |
| (262) 370-5527 | |
| (262) 495-8689 |
| Full Name | Childhood Autism Therapies Llc |
|---|---|
| Speciality | Psychologist - Cognitive & Behavioral |
| Location | N1563 County Road H, Palmyra, Wisconsin |
| Authorized Official Name and Position | Colleen A Ryan (DIRECTOR) |
| Authorized Official Contact | 2623707744 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childhood Autism Therapies Llc N1563 County Road H Palmyra WI 53156-9738 Ph: (262) 370-5527 | Childhood Autism Therapies Llc N1563 County Road H Palmyra WI 53156-9738 Ph: (262) 370-5527 |
| NPI Number | 1144551664 |
|---|---|
| Provider Enumeration Date | 01/22/2010 |
| Last Update Date | 01/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144551664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 2387-57 (Wisconsin) | Secondary |
| 103TB0200X | Psychologist - Cognitive & Behavioral | 2387-57 (Wisconsin) | Primary |
Kettle Moraine Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: N158 Tamarack Rd, Palmyra, WI 53156 Phone: 262-745-0368 |