Organization
FRANK J ELMUDESI PSYD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK J ELMUDESI PSYD LTD PSYD (OWNER)
(251) 847-6207
Entity
Organization
Contact information
Practice address
420 MADISON ST, LAKE GENEVA, WI 53147-1709
(251) 847-3094
Mailing address
420 MADISON ST, LAKE GENEVA, WI 53147-1709
(251) 847-3094
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
39128400
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39128400
—
WI
Enumeration date
10/24/2007
Last updated
01/27/2012
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