| Alliance Psychological And Family Services Llc | |
|
3601 30th Ave Ste. Ll1 Kenosha WI 53144-1695 | |
| (262) 657-9777 | |
| (262) 657-9785 |
| Full Name | Alliance Psychological And Family Services Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 3601 30th Ave, Kenosha, Wisconsin |
| Authorized Official Name and Position | Edward J Donner (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2626579777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Psychological And Family Services Llc 3601 30th Ave Ste. Ll1 Kenosha WI 53144-1695 Ph: (262) 657-9777 | Alliance Psychological And Family Services Llc 3601 30th Ave Ste. Ll1 Kenosha WI 53144-1695 Ph: (262) 657-9777 |
| NPI Number | 1750314159 |
|---|---|
| Provider Enumeration Date | 07/09/2006 |
| Last Update Date | 12/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750314159 | NPI | - | NPPES |
| 39755100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2142057 (Wisconsin) | Primary |
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