Individual
STACY N LORENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 385-7450
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3509
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100072569
—
WI
Enumeration date
09/18/2017
Last updated
10/31/2023
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