Individual
COLLEEN MARY MORTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2727 MARSHALL CT, MADISON, WI 53705-2255
(608) 238-9354
(608) 238-7675
Mailing address
2727 MARSHALL CT, MADISON, WI 53705-2255
(608) 238-9354
(608) 238-7675
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2035
WI
103T00000X
Psychologist
Primary
2035-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39712000
—
WI
Enumeration date
10/12/2006
Last updated
08/04/2015
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