Individual
DR. JACKIE LEE SPLITTER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
6402 ODANA RD, MADISON, WI 53719-1123
(608) 273-4411
Mailing address
W1845 ALPINE RD, BROOKLYN, WI 53521-9202
(608) 455-7070
(608) 455-7070
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
710
WI
Other
Enumeration date
04/21/2006
Last updated
07/08/2007
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