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Individual
MICHAEL CHARLES LUXEM
Active
Individual
MICHAEL CHARLES LUXEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
2707-057
WI
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
LP 4843
MN
Other
Enumeration date
04/29/2009
Last updated
04/29/2009
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