Individual
PETER D LEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2311 N PROSPECT AVE, MILWAUKEE, WI 53211-4445
(414) 319-3000
(414) 319-3011
Mailing address
4425 N PORT WASHINGTON RD, GLENDALE, WI 53212-1082
(414) 326-2218
(414) 326-2208
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3171
WI
Other
Enumeration date
07/16/2014
Last updated
07/16/2014
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