Organization
MADISON NEUROPSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARAH E PORTER PSYD (OWNER)
(608) 841-1606
Entity
Organization
Contact information
Practice address
6510 GRAND TETON PLZ STE 102, STE 24, MADISON, WI 53719
(608) 841-1606
(608) 492-2573
Mailing address
6510 GRAND TETON PLZ STE 102, MADISON, WI 53719-1031
(608) 841-1606
(608) 492-2573
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
3198-57
WI
103TC0700X
Clinical Psychologist
3198-57
WI
Other
Enumeration date
02/29/2016
Last updated
06/21/2018
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