| St. Croix Psychological Clinic | |
|
258 Riverside Dr River Falls WI 54022-3236 | |
| (715) 425-7031 | |
| (715) 425-1055 |
| Full Name | St. Croix Psychological Clinic |
|---|---|
| Speciality | Psychologist |
| Location | 258 Riverside Dr, River Falls, Wisconsin |
| Authorized Official Name and Position | John B. Hamann (WI LIC. PSYCHOLOGIST) |
| Authorized Official Contact | 7154257031 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Croix Psychological Clinic Po Box 425 River Falls WI 54022-0425 Ph: (715) 425-7031 | St. Croix Psychological Clinic 258 Riverside Dr River Falls WI 54022-3236 Ph: (715) 425-7031 |
| NPI Number | 1912181538 |
|---|---|
| Provider Enumeration Date | 12/18/2007 |
| Last Update Date | 12/18/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912181538 | NPI | - | NPPES |
| 39062200 | Medicaid | WI | |
| 1427168079 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 371-057 (Wisconsin) | Primary |
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