Individual
LYNDSEY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
9200 W WISCONSIN AVE, DEPARTMENT OF PSYCHIATRY, MILWAUKEE, WI 53226-3522
(414) 805-3666
Mailing address
9200 W WISCONSIN AVE, DEPARTMENT OF PSYCHIATRY, MILWAUKEE, WI 53226-3522
(414) 805-3666
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3191
WI
103TH0004X
Health Psychologist
3191
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174922066
—
WI
Enumeration date
08/18/2014
Last updated
12/02/2016
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