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Organization
CHILDREN'S HOSPITAL OF WISCONSIN
Active
Organization
CHILDREN'S HOSPITAL OF WISCONSIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETH C LONG PSYD (PEDIATRIC PSYCHOLOGIST)
(414) 266-3047
Entity
Organization
Contact information
Practice address
9000 W WISCONSIN AVE MSC 750, MILWAUKEE, WI 53226-3518
(414) 266-2932
(414) 266-3735
Mailing address
9000 W WISCONSIN AVE MSC 750, PO BOX 1997, MILWAUKEE, WI 53226-3518
(414) 266-2932
(414) 266-3735
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
2530057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40962400
—
WI
Enumeration date
08/20/2006
Last updated
08/22/2020
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