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Individual

CONRAD VICTOR CHRISTENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYCHOLOGIST

Contact information

Practice address
10696 PARK LN, MARSHFIELD, WI 54449-9594
(715) 305-5113
(715) 223-1611
Mailing address
10696 PARK LN, MARSHFIELD, WI 54449-9594
(715) 305-5113
(715) 223-1611

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
289-57
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39064000
WI
Enumeration date
03/10/2014
Last updated
03/10/2014
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