Individual
DR. MELISSA LANCASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-0660
(414) 955-0076
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-0660
(414) 955-0076
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
3374-57
WI
103TC0700X
Clinical Psychologist
3374
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003268061
—
WI
01
—
206147
MEDICARE GROUP PTAN
IL
01
—
F400432863
MEDICARE INDIVIDUAL PTAN
IL
Enumeration date
07/01/2016
Last updated
06/30/2025
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