| Madison Neuropsychological Services Llc | |
|
6510 Grand Teton Plz Ste 102 Ste 24 Madison WI 53719 | |
| (608) 841-1606 | |
| (608) 492-2573 |
| Full Name | Madison Neuropsychological Services Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 6510 Grand Teton Plz Ste 102, Madison, Wisconsin |
| Authorized Official Name and Position | Sarah E Porter (OWNER) |
| Authorized Official Contact | 6088411606 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Madison Neuropsychological Services Llc 6510 Grand Teton Plz Ste 102 Madison WI 53719-1031 Ph: (608) 841-1606 | Madison Neuropsychological Services Llc 6510 Grand Teton Plz Ste 102 Ste 24 Madison WI 53719 Ph: (608) 841-1606 |
| NPI Number | 1982064366 |
|---|---|
| Provider Enumeration Date | 02/29/2016 |
| Last Update Date | 06/21/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982064366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 3198-57 (Wisconsin) | Primary |
| 103TC0700X | Psychologist - Clinical | 3198-57 (Wisconsin) | Secondary |
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