Individual
THERESA L CHINNERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1095 MIDWAY RD, MENASHA, WI 54952-1115
(920) 720-2300
Mailing address
122 E COLLEGE AVE, APPLETON, WI 54911-5794
(920) 996-3264
(920) 830-5970
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
2634
WI
103T00000X
Psychologist
Primary
2634
WI
Other
Enumeration date
12/30/2006
Last updated
01/08/2018
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