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Individual

DR. DAVID E. LACOCQUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
222 S BEDFORD ST, ISTHMUS PSYCHOTHERAPY, LLC, MADISON, WI 53703-3688
(608) 256-6570
(608) 256-4551
Mailing address
702 N BLACKHAWK AVE, SUITE 209, MADISON, WI 53705-3357
(608) 358-6868
(608) 441-3370

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2397057
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39140500
WI
Enumeration date
11/08/2005
Last updated
03/15/2010
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