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Individual

MR. FRANK PAUL URTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
6110 N PORT WASHINGTON RD, GLENDALE, WI 53217-4308
(414) 332-3390
(414) 332-3392
Mailing address
6110 N PORT WASHINGTON RD, CLEAR DIRECTION PSYCHOLOGICAL SERVICES, INC., GLENDALE, WI 53217-4308
(414) 332-3390
(414) 332-3392

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
841057
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
157211
VALUEOPTIONS PROVIDER
WI
01
166708
MANAGED HEALTH NETWORK
WI
05
39020900
WI
01
4017291
AETNA PROVIDER NUMBER
WI
01
522413716013
BLUE CROSS BLUE SHIELD
WI
Enumeration date
10/05/2006
Last updated
04/17/2013
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