Individual
DEBRA HULTQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
150 N SUNNY SLOPE RD STE 100, BROOKFIELD, WI 53005
(262) 432-5600
Mailing address
150 N SUNNY SLOPE RD STE 100, BROOKFIELD, WI 53005-4806
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3454-57
WI
Other
Enumeration date
02/01/2017
Last updated
05/18/2018
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