Individual
DR. MICHAEL DIMARCO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1155 N MAYFAIR RD, THIRD FLOOR, MILWAUKEE, WI 53226-3462
(414) 955-8900
(414) 955-6285
Mailing address
1155 N MAYFAIR RD, THIRD FLOOR, MILWAUKEE, WI 53226-3462
(414) 955-8900
(414) 955-6285
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2311
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013075720
—
WI
05
—
39137100
—
WI
Enumeration date
12/05/2006
Last updated
03/28/2012
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