Healthcare Provider Details

I. General information

NPI: 1750440590
Provider Name (Legal Business Name): JOSHUA BRANDT SCHIFFMAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2006
Last Update Date: 07/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6314 ODANA RD STE E
MADISON WI
53719-1129
US

IV. Provider business mailing address

6314 ODANA RD STE E
MADISON WI
53719-1129
US

V. Phone/Fax

Practice location:
  • Phone: 608-347-9582
  • Fax:
Mailing address:
  • Phone: 608-347-9582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2551-057
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: