Individual
DR. TERI L. KACZMAREK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
210 WISCONSIN AMERICAN DR, FOND DU LAC, WI 54937-2999
(920) 907-7000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2066-57
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39143700
—
WI
Enumeration date
05/10/2011
Last updated
05/21/2024
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