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Individual

LORI WERRES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1500 W ROGERS AVE, APPLETON, WI 54914-5007
(920) 954-6804
(920) 954-6806
Mailing address
300 CROOKS ST, GREEN BAY, WI 54301-4527
(920) 436-4360
(920) 437-3540

Taxonomy

Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40906900
WI
Enumeration date
10/29/2007
Last updated
10/29/2007
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