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Organization

PROVIDENCE PSYCHIATRIC SERVICES S C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY L PINTARRO APNP (PRESIDENT)
(414) 239-3172
Entity
Organization

Contact information

Practice address
333 BISHOPS WAY STE 102, BROOKFIELD, WI 53005-6209
(414) 239-3172
Mailing address
333 BISHOPS WAY STE 102, BROOKFIELD, WI 53005-6209
(414) 239-3172

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Enumeration date
06/04/2022
Last updated
06/04/2022
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