Individual
DR. JACK E SHERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
600 HIGHLAND AVE, COMPLIANCE MAIL CODE-2433, MADISON, WI 53792-0001
(608) 263-1457
Mailing address
7633 GANSER WAY, STE 204, MADISON, WI 53719-2092
(608) 829-1800
(608) 829-1885
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1406-57
WI
103TC0700X
Clinical Psychologist
1406
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1406-57
PHYSC
WI
Enumeration date
07/21/2006
Last updated
05/13/2015
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