Individual
RICHARD J. ERTL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2266 N PROSPECT AVE, SUITE 510, MILWAUKEE, WI 53202-6319
(414) 226-0137
(414) 226-0137
Mailing address
2266 N PROSPECT AVE, SUITE 510, MILWAUKEE, WI 53202-6319
(414) 226-0137
(414) 226-0137
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1767-057
WI
103TC0700X
Clinical Psychologist
Primary
1767-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39101700
—
WI
01
—
R60582
UPIN
WI
Enumeration date
09/26/2006
Last updated
07/09/2010
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