Individual
MARILYN ELIZABETH BOHATKIEWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2200 DICKINSON RD UNIT 4, SUITE B, DE PERE, WI 54115-4056
(920) 347-3500
(920) 347-3501
Mailing address
2200 DICKINSON RD UNIT 4, SUITE B, DE PERE, WI 54115-4056
(920) 347-3500
(920) 347-3501
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1180057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39040500
—
WI
Enumeration date
11/06/2006
Last updated
02/24/2014
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