Organization
INNER RESOURCES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA LYNN PAULY PHD. (OWNER)
(262) 789-7100
Entity
Organization
Contact information
Practice address
12545 W BURLEIGH RD, SUITE 1, BROOKFIELD, WI 53005-3101
(262) 789-7100
Mailing address
12545 W BURLEIGH RD, SUITE 1, BROOKFIELD, WI 53005-3101
(262) 789-7100
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1434
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000088102
MEDICARE PTAN
WI
05
—
42188100
—
WI
Enumeration date
07/22/2006
Last updated
01/02/2014
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