Organization
PROFESSIONAL PSYCHOLOGICAL SERVICES, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEAN EDWARD STOLLDORF PHD (CLINICAL DIRECTOR)
(262) 767-0440
Entity
Organization
Contact information
Practice address
441 MILWAUKEE AVE STE 2, BURLINGTON, WI 53105-1230
(262) 767-0440
(262) 767-0777
Mailing address
441 MILWAUKEE AVE STE 2, BURLINGTON, WI 53105-1230
(262) 767-0440
(262) 767-0777
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1746
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42155900
—
WI
Enumeration date
01/22/2008
Last updated
01/22/2008
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