Organization
GENESIS COUNSELING GROUP, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY R GREGG PSY.D. (PRESIDENT CLINICAL PSYCHOLOGIST)
(262) 780-0991
Entity
Organization
Contact information
Practice address
890 ELM GROVE RD, SUITE 4, ELM GROVE, WI 53122-2528
(262) 780-0991
(262) 780-0992
Mailing address
890 ELM GROVE RD, SUITE 4, ELM GROVE, WI 53122-2528
(262) 780-0991
(262) 780-0992
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2195
WI
Other
Enumeration date
04/13/2007
Last updated
08/22/2020
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