Organization
MYLES TONNACLIFF PH.D, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYLES D TONNACLIFF LP (LICESED PSYCHOLOGIST- OWNER)
(262) 618-2856
Entity
Organization
Contact information
Practice address
W62N248 WASHINGTON AVE, SUITE 208, CEDARBURG, WI 53012-2768
(262) 618-2856
Mailing address
W62N248 WASHINGTON AVE, SUITE 208, CEDARBURG, WI 53012-2768
(414) 617-2663
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
2163-57
WI
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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