Organization
BENJAMIN DE BOER PSYD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN I DE BOER PSYD (OWNER)
(608) 886-9697
Entity
Organization
Contact information
Practice address
2916 MARKETPLACE DR., SUITE 206 & 207, FITCHBURG, WI 53719
(608) 886-9697
Mailing address
2800 E ENTERPRISE AVE STE 333, APPLETON, WI 54913-7889
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
07/01/2024
Last updated
01/18/2026
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