Individual
DR. JACQUELINE BORTHWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
161 W WISCONSIN AVE, PEWAUKEE, WI 53072-3467
(262) 695-8857
(262) 695-8879
Mailing address
161 W WISCONSIN AVE, PEWAUKEE, WI 53072-3467
(262) 695-8857
(262) 695-8879
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3354-57
WI
103TC2200X
Clinical Child & Adolescent Psychologist
3354-57
WI
Other
Enumeration date
07/28/2016
Last updated
07/29/2016
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