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Individual

DR. LOUISE M ENNIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
7617 MINERAL POINT RD, STE300, MADISON, WI 53717-1623
(608) 833-9290
(608) 833-9691
Mailing address
7617 MINERAL POINT RD, STE300, MADISON, WI 53717-1623
(608) 833-9290
(608) 833-9691

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
2033-057
WI
103TC0700X
Clinical Psychologist
Primary
2033-57
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39728800
WI
Enumeration date
09/17/2006
Last updated
01/19/2011
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