Individual
DR. RAYMOND CHARLES LIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 775-9000
(608) 775-4494
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 775-9000
(608) 775-4494
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2060
WI
103G00000X
Clinical Neuropsychologist
5565
MN
Other
Enumeration date
01/13/2006
Last updated
09/21/2016
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