Organization
WISCONSIN GERIATRIC PSYCHOLOGICAL SERVICES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA C STANIK PH.D (PSYCHOLOGIST)
(414) 444-9811
Entity
Organization
Contact information
Practice address
3254 S 86TH ST, MILWAUKEE, WI 53227-4620
(718) 268-6600
(718) 268-6065
Mailing address
3254 S 86TH ST, MILWAUKEE, WI 53227-4620
(718) 268-6600
(718) 268-6065
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1998-57
WI
Other
Enumeration date
05/03/2011
Last updated
03/22/2013
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