Organization
PSYCHOLOGIE CLINIQUE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VALERIE AMELIE DELAIN PH.D. (PRESIDENT)
(920) 437-4490
Entity
Organization
Contact information
Practice address
130 E WALNUT ST, SUITE 410, GREEN BAY, WI 54301-4239
(920) 437-4490
(920) 437-4492
Mailing address
130 E WALNUT ST, SUITE 410, GREEN BAY, WI 54301-4239
(920) 437-4490
(920) 437-4492
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1530
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0810003479
LICENSED CLINICAL PSYCHOL
VA
01
—
1530
LICENSED PSYCHOLOGIST
WI
Enumeration date
06/13/2007
Last updated
08/22/2020
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