| Professional Psychological Services, Sc | |
|
441 Milwaukee Ave Ste 2 Burlington WI 53105-1230 | |
| (262) 767-0440 | |
| (262) 767-0777 |
| Full Name | Professional Psychological Services, Sc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 441 Milwaukee Ave Ste 2, Burlington, Wisconsin |
| Authorized Official Name and Position | Dean Edward Stolldorf (CLINICAL DIRECTOR) |
| Authorized Official Contact | 2627670440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Psychological Services, Sc 441 Milwaukee Ave Ste 2 Burlington WI 53105-1230 Ph: (262) 767-0440 | Professional Psychological Services, Sc 441 Milwaukee Ave Ste 2 Burlington WI 53105-1230 Ph: (262) 767-0440 |
| NPI Number | 1134306103 |
|---|---|
| Provider Enumeration Date | 01/22/2008 |
| Last Update Date | 01/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134306103 | NPI | - | NPPES |
| 42155900 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1746 (Wisconsin) | Primary |
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