Individual
MICHELLE LOMAN MOUDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-9248
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-9248
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
WI
103TC0700X
Clinical Psychologist
3182-57
WI
Other
Enumeration date
07/14/2014
Last updated
08/29/2014
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