Individual
EDWARD M RUBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY D
Contact information
Practice address
1020 N 12TH ST, OUTPT HEALTH CENTER 4TH FLOOR, MILWAUKEE, WI 53233-1308
(414) 219-5000
(414) 219-5422
Mailing address
1220 DEWEY AVE, WAUWATOSA, WI 53213-2504
(414) 454-6600
(414) 454-6450
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1361057
WI
103TH0004X
Health Psychologist
1361-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39080300
—
WI
Enumeration date
07/18/2006
Last updated
07/09/2010
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