| Healthy Minds Of The Fox Valley Llc | |
|
1045 N Lynndale Dr Ste 1c Appleton WI 54914-3048 | |
| (902) 551-0013 | |
| Not Available |
| Full Name | Healthy Minds Of The Fox Valley Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1045 N Lynndale Dr, Appleton, Wisconsin |
| Authorized Official Name and Position | Tammy Lee Hietpas (OWNER) |
| Authorized Official Contact | 7159378819 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Minds Of The Fox Valley Llc 6188 Clarks Rd Winneconne WI 54986-9760 Ph: (908) 551-0013 | Healthy Minds Of The Fox Valley Llc 1045 N Lynndale Dr Ste 1c Appleton WI 54914-3048 Ph: (902) 551-0013 |
| NPI Number | 1518346261 |
|---|---|
| Provider Enumeration Date | 05/28/2015 |
| Last Update Date | 06/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518346261 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 72200-1519 (Wisconsin) | Primary |
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