Individual
DR. MICHAEL JOHN MANDLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
10265 WEST NORTH AVE, SUITE 103, WAUWATOSA, WI 53226
(414) 617-2656
Mailing address
W158N10263 MOHAWK DR, GERMANTOWN, WI 53022-4853
(414) 617-2656
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1445-057
WI
Other
Enumeration date
08/24/2009
Last updated
08/24/2009
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