Organization
AUTISM INTERVENTION MILWAUKEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHLEEN BRODERICK WOODY PSY.D. (CLINIC DIRECTOR)
(414) 256-0077
Entity
Organization
Contact information
Practice address
2645 N MAYFAIR RD, SUITE 250, WAUWATOSA, WI 53226-1304
(414) 256-0077
(414) 256-0090
Mailing address
2645 N MAYFAIR RD, SUITE 250, WAUWATOSA, WI 53226-1304
(414) 256-0077
(414) 256-0090
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2041-057
WI
Other
Enumeration date
03/17/2010
Last updated
03/17/2010
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