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Organization

COMMUNITY PSYCHOLOGICAL SERVICES OF WAUPUN LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT NORMAN DEYOUNG PH D (PSYCHOLOGIST CO-OWNER)
(920) 324-4358
Entity
Organization

Contact information

Practice address
1208 S WATERTOWN ST, WAUPUN, WI 53963-2309
(920) 324-4358
Mailing address
1208 S WATERTOWN ST, WAUPUN, WI 53963-2309
(920) 324-4358
(920) 324-4737

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1228
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42127800
WI
Enumeration date
09/22/2006
Last updated
08/22/2020
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