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Individual

MRS. MARTHA L RUNGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-2203
(414) 384-2000
(414) 382-5298
Mailing address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-2203
(414) 384-2000
(414) 382-5298

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
WI2069
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39650200
WI
Enumeration date
06/07/2006
Last updated
02/26/2014
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