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Individual

DR. ROBERT MICHAEL DRIES

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
8112 W BLUEMOUND RD, STE 106, WAUWATOSA, WI 53213-3356
(414) 258-6813
(414) 431-1071
Mailing address
8112 W BLUEMOUND RD, STE 106, WAUWATOSA, WI 53213-3356
(414) 258-6813
(414) 431-1071

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0593
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39053100
WI
Enumeration date
06/14/2006
Last updated
07/08/2007
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