Organization
FORWARD PSYCHOLOGY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDON HERZ PHD (MANAGING MEMBER)
(608) 833-7533
Entity
Organization
Contact information
Practice address
478 COMMERCE DR STE 204, MADISON, WI 53719-5099
(608) 833-7533
Mailing address
478 COMMERCE DR STE 204, MADISON, WI 53719-5099
(608) 833-7533
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
WI 1715
WI
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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