| Benjamin De Boer Psyd Llc | |
|
2824 Frisee Dr Fitchburg WI 53711-8502 | |
| (608) 886-9697 | |
| Not Available |
| Full Name | Benjamin De Boer Psyd Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2824 Frisee Dr, Fitchburg, Wisconsin |
| Authorized Official Name and Position | Benjamin I De Boer (OWNER) |
| Authorized Official Contact | 6088869697 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin De Boer Psyd Llc 2800 E Enterprise Ave Ste 333 Appleton WI 54913-7889 Ph: () - | Benjamin De Boer Psyd Llc 2824 Frisee Dr Fitchburg WI 53711-8502 Ph: (608) 886-9697 |
| NPI Number | 1992540876 |
|---|---|
| Provider Enumeration Date | 07/01/2024 |
| Last Update Date | 07/01/2024 |
| Certification Date | 07/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992540876 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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