Organization
AUTISM AND BEHAVIOR CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTIN M WEGNER PHD (CLINICAL PSYCHOLOGIST)
(715) 598-7121
Entity
Organization
Contact information
Practice address
919 S. HILLCREST PKWY, ALTOONA, WI 54720-2775
(715) 598-7121
(715) 598-7123
Mailing address
919 S. HILLCREST PKWY, ALTOONA, WI 54720-2775
(715) 598-7121
(715) 598-7123
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40984200
—
WI
05
—
42250800
—
WI
Enumeration date
04/04/2007
Last updated
11/25/2015
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