Organization
ALLIANCE PSYCHOLOGICAL AND FAMILY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD J DONNER PH.D. (CLINICAL PSYCHOLOGIST)
(262) 657-9777
Entity
Organization
Contact information
Practice address
3601 30TH AVE, STE. LL1, KENOSHA, WI 53144-1695
(262) 657-9777
(262) 657-9785
Mailing address
3601 30TH AVE, STE. LL1, KENOSHA, WI 53144-1695
(262) 657-9777
(262) 657-9785
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2142057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39755100
—
WI
Enumeration date
07/09/2006
Last updated
12/12/2012
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