Individual
DANIEL M CHRISTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
146 E GENEVA SQ, LAKE GENEVA, WI 53147-9694
(262) 249-4620
Mailing address
146 E GENEVA SQ, LAKE GENEVA, WI 53147-9694
(262) 249-4620
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2872-057
WI
103TC0700X
Clinical Psychologist
071006339
IL
103TC0700X
Clinical Psychologist
2872-057
WI
Other
Enumeration date
08/15/2006
Last updated
06/07/2016
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