Individual
DR. MYLES D TONNACLIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
W62N248 WASHINGTON AVE STE 208, CEDARBURG, WI 53012-2768
(262) 618-2856
Mailing address
W62N248 WASHINGTON AVE STE 208, CEDARBURG, WI 53012-2768
(622) 618-2856
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2282-125
WI
103T00000X
Psychologist
Primary
2163-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2163-057
LICENSED PSYCHOLOGIST
WI
05
—
39154700
—
WI
Enumeration date
02/23/2007
Last updated
03/10/2020
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