Organization
CHANGEQUEST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNE M FORS SPAHR PH.D. (CLINICAL PSYCHOLOGIST)
(262) 261-4698
Entity
Organization
Contact information
Practice address
11345 N PORT WASHINGTON RD, SUITE 202, MEQUON, WI 53092
(262) 261-4698
Mailing address
11345 N PORT WASHINGTON RD, SUITE 202, MEQUON, WI 53092
(262) 261-4698
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083737068
SELF
WI
Enumeration date
08/28/2024
Last updated
08/28/2024
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