Individual
SHELLEY BOEHM MATTIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4845 MORRIS CT, WAUNAKEE, WI 53597-9164
(920) 965-6768
(920) 965-6769
Mailing address
215 S CENTURY AVE STE 128, WAUNAKEE, WI 53597-1249
(920) 965-6768
(920) 965-6769
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
39641
WI
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
01/09/2007
Last updated
11/29/2023
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