Organization
PSYCHOLOGICAL HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER A HEINEMANN PH.D (OWNER)
(262) 646-6280
Entity
Organization
Contact information
Practice address
19435 W CAPITOL DRIVE, SUITE L03, BROOKFIELD, WI 53045-2738
(262) 646-6280
(262) 646-6284
Mailing address
PO BOX 180680, DELAFIELD, WI 53018-0680
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2333-057
WI
Other
Enumeration date
06/25/2006
Last updated
11/25/2013
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