Organization
LAURI GEBHARD
Active
Parent organization
LAURI GEBHARD
Other names
mind-body program
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAURI GEBHARD
Authorized official
DR. LAURI CHRISTINE GEBHARD PH.D (PSYCHOLOGIST, DIRECTOR)
(414) 407-6664
Entity
Organization
Contact information
Practice address
10855 W POTTER RD, WAUWATOSA, WI 53226-3439
(414) 407-6664
(414) 302-1330
Mailing address
10855 W POTTER RD, WAUWATOSA, WI 53226-3439
(414) 407-6664
(414) 302-1339
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2028
WI
103TB0200X
Cognitive & Behavioral Psychologist
2028
WI
103TC0700X
Clinical Psychologist
Primary
2028
WI
103TH0004X
Health Psychologist
2028
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39121000
—
WI
Enumeration date
09/22/2007
Last updated
09/22/2007
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