Individual
DR. JOAN R. NUTTALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
10701 W NORTH AVE, SUITE 202, WAUWATOSA, WI 53226-2314
(414) 771-2450
(414) 771-2451
Mailing address
10701 W NORTH AVE, SUITE 202, WAUWATOSA, WI 53226-2314
(414) 771-2450
(414) 771-2451
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
742-057
WI
Other
Enumeration date
06/17/2007
Last updated
07/08/2007
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