Healthcare Provider Details

I. General information

NPI: 1669382313
Provider Name (Legal Business Name): PATRICK FRANKENTHAL ED.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 W VLIET ST
MILWAUKEE WI
53208-2698
US

IV. Provider business mailing address

N30W22108 WOODFIELD CT W
WAUKESHA WI
53186-8874
US

V. Phone/Fax

Practice location:
  • Phone: 414-393-2100
  • Fax:
Mailing address:
  • Phone: 224-636-4469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number3001029806
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: