Individual
STEVE ELLMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
W350S1401 WATERVILLE RD, DOUSMAN, WI 53118-9020
(262) 965-2131
Mailing address
W350S1401 WATERVILLE RD, DOUSMAN, WI 53118-9020
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39717300
—
WI
Enumeration date
04/17/2008
Last updated
04/17/2008
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