| Inner Resources Inc. | |
|
12545 W Burleigh Rd Suite 1 Brookfield WI 53005-3101 | |
| (262) 789-7100 | |
| Not Available |
| Full Name | Inner Resources Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 12545 W Burleigh Rd, Brookfield, Wisconsin |
| Authorized Official Name and Position | Laura Lynn Pauly (OWNER) |
| Authorized Official Contact | 2627897100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Resources Inc. 12545 W Burleigh Rd Suite 1 Brookfield WI 53005-3101 Ph: (262) 789-7100 | Inner Resources Inc. 12545 W Burleigh Rd Suite 1 Brookfield WI 53005-3101 Ph: (262) 789-7100 |
| NPI Number | 1932120029 |
|---|---|
| Provider Enumeration Date | 07/22/2006 |
| Last Update Date | 01/02/2014 |
| Medicare PECOS PAC ID | 2264338490 |
|---|---|
| Medicare Enrollment ID | O20031209000869 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932120029 | NPI | - | NPPES |
| 42188100 | Medicaid | WI | |
| 000088102 | Other | WI | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1434 (Wisconsin) | Primary |
| Provider Name | Laura L Pauly |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871530162 PECOS PAC ID: 4789580929 Enrollment ID: I20031209000925 |
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