| Stacy L Killinger, Phd Llc | |
|
6300 Enterprise Ln # 208 Madison WI 53719-1190 | |
| (608) 707-9444 | |
| (608) 621-3798 |
| Full Name | Stacy L Killinger, Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 6300 Enterprise Ln # 208, Madison, Wisconsin |
| Authorized Official Name and Position | Stacy Lee Killinger (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 6087079444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stacy L Killinger, Phd Llc 6300 Enterprise Ln # 208 Madison WI 53719-1190 Ph: (608) 707-9444 | Stacy L Killinger, Phd Llc 6300 Enterprise Ln # 208 Madison WI 53719-1190 Ph: (608) 707-9444 |
| NPI Number | 1528432739 |
|---|---|
| Provider Enumeration Date | 11/25/2015 |
| Last Update Date | 11/28/2023 |
| Certification Date | 11/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528432739 | NPI | - | NPPES |
| 100048496 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 3310 (Wisconsin) | Primary |
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