Individual
DR. JOHN CHARLES IVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
500 RIVERVIEW AVE, WAUKESHA, WI 53188-3632
(262) 548-7665
(262) 548-7656
Mailing address
16960 BURLEIGH PL, BROOKFIELD, WI 53005-2753
(262) 548-7665
(262) 548-7656
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
1323
WI
Other
Enumeration date
12/19/2006
Last updated
07/08/2007
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