Individual
DR. CHRISTOPHER PAUL WIEBUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
N27W23953 PAUL RD, STE. 206, PEWAUKEE, WI 53072-6242
(262) 347-0701
(262) 347-0705
Mailing address
N27W23953 PAUL RD, STE. 206, PEWAUKEE, WI 53072-6242
(262) 347-0701
(262) 347-0705
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
1920 057
WI
103T00000X
Psychologist
Primary
1920
WI
103TC2200X
Clinical Child & Adolescent Psychologist
1920 057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39126000
—
WI
Enumeration date
04/19/2007
Last updated
08/03/2021
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