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Individual

PAUL W THORESEN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
621 SCIENCE DR, MADISON, WI 53711
(608) 265-8348
(608) 833-6932
Mailing address
8007 EXCELSIOR DR, MADISON, WI 53717
(608) 829-5201
(608) 833-6932

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
162
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39027800
WI
Enumeration date
04/18/2006
Last updated
07/08/2007
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