Individual
DIANA MARIE VAN DE KREEKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1313 FISH HATCHERY RD, MADISON, WI 53715-1911
(608) 252-8000
(608) 283-7351
Mailing address
1313 FISH HATCHERY RD, MADISON, WI 53715-1911
(608) 252-8000
(608) 283-7351
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
3660-57
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134500234
—
WI
Enumeration date
06/15/2015
Last updated
12/15/2020
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