Individual
MACKENZIE TARA GOERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
9200 W WISCONSIN AVENUE, PSYCHIATRY AND PSYCHOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3666
(414) 955-6285
Mailing address
9200 W WISCONSIN AVENUE, PSYCHIATRY AND PSYCHOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3666
(414) 955-6285
Taxonomy
Speciality
Code
Description
License number
State
103TH0004X
Health Psychologist
Primary
508757
WI
Other
Enumeration date
07/21/2023
Last updated
09/05/2023
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