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Individual

GREGORY D PRICHETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY

Contact information

Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1762
WI
103TC0700X
Clinical Psychologist
1762
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39103500
WI
Enumeration date
06/13/2005
Last updated
11/21/2014
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