Individual
NANCY L GORANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-4200
(920) 926-8885
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8343
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1826
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39131800
—
WI
Enumeration date
08/08/2006
Last updated
10/27/2022
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