Individual
ERIC D SEYBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
12690 W NORTH AVE, BROOKFIELD, WI 53005-4636
(262) 785-1008
(262) 785-0644
Mailing address
12630 W NORTH AVE, BLDG E, BROOKFIELD, WI 53005-4626
(262) 785-1008
(262) 432-9059
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2494-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39769500
—
WI
Enumeration date
05/19/2006
Last updated
01/15/2018
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