Organization
NORTHERN WISCONSIN GERIATRIC PSYCHOLOGICAL SERVICES, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONSTANCE L WOYTHAL PSYD (OWNER)
(920) 893-8000
Entity
Organization
Contact information
Practice address
859 CHAPLIN CT, PLYMOUTH, WI 53073-1012
(920) 893-8000
Mailing address
PO BOX 750834, FOREST HILLS, NY 11375-0834
(718) 268-6600
(718) 268-6065
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2322-57
WI
Other
Enumeration date
02/19/2015
Last updated
02/19/2015
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