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Individual

DR. PATRICIA CAROL STANIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
2448 S 102ND ST, SUITE 270, WEST ALLIS, WI 53227-2466
(414) 800-7645
(414) 800-7647
Mailing address
2448 S 102ND ST, SUITE 201, WEST ALLIS, WI 53227-2466
(414) 800-7645
(414) 800-7647

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
1998
WI
103T00000X
Psychologist
103TC0700X
Clinical Psychologist
Primary
1998
WI
103TR0400X
Rehabilitation Psychologist
1998
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1998
STATE LICENSE
WI
Enumeration date
10/17/2006
Last updated
11/14/2019
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