Individual
DAVID T MARX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
4536 22ND AVE, KENOSHA, WI 53140-5917
(262) 656-0044
(262) 653-2218
Mailing address
301 TROY DR, MADISON, WI 53704-1521
(608) 301-1235
(608) 301-1236
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3010-57
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3010-57
STATE LICENSE
WI
Enumeration date
06/06/2013
Last updated
11/13/2013
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