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Organization

HEALTHY MINDS OF THE FOX VALLEY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAMMY LEE HIETPAS PHD (OWNER)
(715) 937-8819
Entity
Organization

Contact information

Practice address
1045 N LYNNDALE DR, STE 1C, APPLETON, WI 54914-3048
(902) 551-0013
Mailing address
6188 CLARKS RD, WINNECONNE, WI 54986-9760
(908) 551-0013

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
72200-1519
WI

Other

Enumeration date
05/28/2015
Last updated
06/10/2015
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