Individual
DR. MICHAEL J VITACCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
301 TROY DR, MADISON, WI 53704-1521
(608) 301-1000
Mailing address
301 TROY DR, MADISON, WI 53704-1521
(608) 301-1000
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
2794-57
WI
Other
Enumeration date
03/23/2009
Last updated
03/23/2009
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