Individual
MATTHEW DAVID JANDRISEVITS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-2932
(414) 266-3735
Mailing address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-2932
(414) 266-3735
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2678057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740477751
—
WI
Enumeration date
10/03/2007
Last updated
05/07/2021
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