| Inside Out Counseling And Diagnostic Center, Llc | |
|
104 S Main St Suite 711 Fond Du Lac WI 54935-4269 | |
| (920) 322-9100 | |
| (920) 322-9493 |
| Full Name | Inside Out Counseling And Diagnostic Center, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 104 S Main St, Fond Du Lac, Wisconsin |
| Authorized Official Name and Position | Peggy A Dennison (OWNER) |
| Authorized Official Contact | 9203229100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inside Out Counseling And Diagnostic Center, Llc 104 S Main St Suite 711 Fond Du Lac WI 54935-4269 Ph: (920) 322-9100 | Inside Out Counseling And Diagnostic Center, Llc 104 S Main St Suite 711 Fond Du Lac WI 54935-4269 Ph: (920) 322-9100 |
| NPI Number | 1366567174 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366567174 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 2394-057 (Wisconsin) | Primary |
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