Healthcare Provider Details

I. General information

NPI: 1518916485
Provider Name (Legal Business Name): DORI ANN BISCHMANN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 E NEWPORT AVE #409
MILWAUKEE WI
53211-2984
US

IV. Provider business mailing address

PO BOX 11947
MILWAUKEE WI
53211-0947
US

V. Phone/Fax

Practice location:
  • Phone: 414-259-3900
  • Fax: 414-963-0000
Mailing address:
  • Phone: 414-259-3900
  • Fax: 414-963-0000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1605-057
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: