Mary Alice Herzog PHD

NPI 1407901325 - Psychologist - 103T00000X

NPI Details
NPI 1407901325
Gender Female
Enumeration Date 01/23/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
933 N MAYFAIR RD
303
WAUWATOSA WI, 53226, US
Phone (414) 582-8488
Fax (414) 258-8838
Business Location
933 N MAYFAIR RD
303
WAUWATOSA WI, 53226, US
Phone (414) 582-8488
Fax (414) 258-8838
Toxanomy
Taxonomy Code 103T00000X
License State Wisconsin
License Number 843
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According to our database, Dr. Mary Alice Herzog PHD NPI is 1407901325, taxonomy code is 103T00000X and license number is 843, license state is located at Wisconsin. Mary Alice Herzog PHD physically located at 933 N Mayfair Rd, Wauwatosa WI, 53226. NPI Number Mary Alice Herzog PHD has the Individual type.

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1407901325 NPI number is provided on an as is basis without warranty of any kind. 1407901325 is maintained by the National Plan & Provider Enumeration System. The contents of Mary Alice Herzog PHD are for informational purposes only.