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Individual

DR. ALLA Y LIKHTEREV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
WINNEBAGO MENTAL HEALTH INSTITUTE 1300 SOUTH DRIVE, WINNEBAGO, WI 54985-0009
(920) 235-4910
(920) 236-2931
Mailing address
WINNEBAGO MENTAL HEALTH INSTITUTE1300 SOUTH DRIVE, 1300 SOUTH DRIVE, WINNEBAGO, WI 54985-0009
(920) 235-4910
(920) 236-2931

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
37144
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32282700
WI
01
37144
LICENSE NUMBER
WI
Enumeration date
12/12/2006
Last updated
03/07/2023
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