| Collaborative Psychotherapy, Llc | |
|
6793 N Green Bay Ave Glendale WI 53209-3422 | |
| (414) 292-3900 | |
| (414) 292-3901 |
| Full Name | Collaborative Psychotherapy, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 6793 N Green Bay Ave, Glendale, Wisconsin |
| Authorized Official Name and Position | Terence Michael Gunville (PSYCHOTHERAPIST) |
| Authorized Official Contact | 4142923900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Collaborative Psychotherapy, Llc 8961 W Palmetto Ct Milwaukee WI 53225-5017 Ph: (414) 536-8604 | Collaborative Psychotherapy, Llc 6793 N Green Bay Ave Glendale WI 53209-3422 Ph: (414) 292-3900 |
| NPI Number | 1669731972 |
|---|---|
| Provider Enumeration Date | 05/07/2012 |
| Last Update Date | 05/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669731972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 835-123 (Wisconsin) | Primary |
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