Individual
ANGELA M ORVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
4555 W SCHROEDER DR, BROWN DEER, WI 53223-1475
(800) 767-4411
(414) 797-0804
Mailing address
34700 VALLEY RD, OCONOMOWOC, WI 53066-4599
(800) 767-4411
(262) 646-1049
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
3628-57
WI
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
3628-57
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3628-57
STATE LICENSE
WI
Enumeration date
01/11/2019
Last updated
01/11/2019
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