Individual
DEBRA L ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2901 W KINNICKINNIC RIVER PKWY, SUITE 301, MILWAUKEE, WI 53215-3677
(414) 385-8771
(414) 385-2399
Mailing address
2901 W KINNICKINNIC RIVER PKWY, SUITE 301, MILWAUKEE, WI 53215-3677
(414) 385-8771
(414) 385-2399
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1495
WI
103TC0700X
Clinical Psychologist
1495
WI
103TH0004X
Health Psychologist
1495
WI
Other
Enumeration date
02/17/2010
Last updated
07/02/2010
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