Individual
TIMOTHY W. LICHTENWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1809
WI
Other
Enumeration date
03/09/2012
Last updated
03/09/2012
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