Individual
MARIANNE NILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
459 E 1ST ST, FOND DU LAC, WI 54935-4505
(920) 929-3554
Mailing address
459 E 1ST ST, FOND DU LAC, WI 54935-4505
(920) 929-3554
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810005263
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39683600
—
WI
Enumeration date
04/19/2007
Last updated
10/24/2025
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