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101 N. Farwell Street Ste. 204 Eau Claire WI 54703 | |
| (715) 514-4600 | |
| (715) 514-4008 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Cognitive & Behavioral |
| Location | 101 N. Farwell Street, Eau Claire, Wisconsin |
| Authorized Official Name and Position | Anton C Smets (OWNER/PRESIDENT) |
| Authorized Official Contact | 7155144600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
101 N. Farwell Street Ste. 204 Eau Claire WI 54703 Ph: (715) 514-4600 | 101 N. Farwell Street Ste. 204 Eau Claire WI 54703 Ph: (715) 514-4600 |
| NPI Number | 1619081437 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 11/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619081437 | NPI | - | NPPES |
| 412144500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | 1720 (Wisconsin) | Primary |
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