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Individual

AMANDA C MESSINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5303 W NORTH AVE, MILWAUKEE, WI 53208
(414) 445-0997
(414) 445-0989
Mailing address
5303 W NORTH AVE, MILWAUKEE, WI 53208-1021
(414) 445-0997
(414) 445-0989

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3000-057
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100020246
WI
Enumeration date
11/17/2011
Last updated
08/03/2018
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