Individual
MR. LARRY KEVIN HAMBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2400 W VILLARD AVE, WFHC GLENDALE FAMILY CENTER, MILWAUKEE, WI 53209-4901
(414) 527-8458
(414) 527-8045
Mailing address
2400 W VILLARD AVE, WFHC GLENDALE FAMILY CENTER, MILWAUKEE, WI 53209-4901
(414) 527-8458
(414) 527-8045
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1004
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000119L
HUMANA
—
05
—
1780635524
—
WI
Enumeration date
05/15/2006
Last updated
01/24/2013
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