Organization
PLOVER PSYCHOLOGICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON M PALLEN (EXECUTIVE MANAGER)
(715) 347-5570
Entity
Organization
Contact information
Practice address
2840 POST RD, PLOVER, WI 54467-3443
(715) 347-5570
(715) 347-5560
Mailing address
2840 POST RD, PLOVER, WI 54467-3443
(715) 347-5570
(715) 347-5560
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42243400
—
WI
Enumeration date
02/02/2007
Last updated
08/22/2020
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