Organization
PEDIATRIC PSYCHOLOGY ASSOCIATES LLC
Active
Other names
Autism Behavioral Network
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY R PRITZL PSYD, BCBA-D (DIRECTOR OWNER)
(414) 476-9755
Entity
Organization
Contact information
Practice address
3636 N 124TH ST, 3RD FLOOR, WAUWATOSA, WI 53222-2125
(414) 476-9755
(414) 476-3413
Mailing address
3636 N 124TH ST, 3RD FLOOR, WAUWATOSA, WI 53222-2125
(414) 476-9755
(414) 476-3413
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
613 057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42212500
—
WI
Enumeration date
11/22/2006
Last updated
09/27/2016
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