| Childynamics Llc | |
|
11904 W North Ave Suite 110 Wauwatosa WI 53226-2062 | |
| (414) 258-4318 | |
| Not Available |
| Full Name | Childynamics Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11904 W North Ave, Wauwatosa, Wisconsin |
| Authorized Official Name and Position | Isabela Sardas (PHD) |
| Authorized Official Contact | 4142584318 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childynamics Llc 11904 W North Ave Suite 110 Wauwatosa WI 53226-2062 Ph: (414) 258-4318 | Childynamics Llc 11904 W North Ave Suite 110 Wauwatosa WI 53226-2062 Ph: (414) 258-4318 |
| NPI Number | 1235304692 |
|---|---|
| Provider Enumeration Date | 04/28/2008 |
| Last Update Date | 04/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235304692 | NPI | - | NPPES |
| 42216000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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