Organization
PSYCHOLOGY CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ROETHE PH.D. (PSYCHOLOGIST/CO-DIRECTOR)
(608) 280-6486
Entity
Organization
Contact information
Practice address
702 N BLACKHAWK AVE STE 212, MADISON, WI 53705-3357
(608) 238-9991
(608) 238-1929
Mailing address
702 N BLACKHAWK AVE STE 212, MADISON, WI 53705-3357
(608) 238-9991
(608) 238-1929
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
1919
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42161100
—
WI
Enumeration date
10/21/2006
Last updated
03/05/2025
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