Healthcare Provider Details

I. General information

NPI: 1326268236
Provider Name (Legal Business Name): DEBORAH A STEC PHD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 04/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2717 N GRANDVIEW BLVD STE 202
WAUKESHA WI
53188
US

IV. Provider business mailing address

S32W31791 SQUIRE COURT
WAUKESHA WI
53189
US

V. Phone/Fax

Practice location:
  • Phone: 262-513-0700
  • Fax: 262-513-0707
Mailing address:
  • Phone: 262-513-0700
  • Fax: 262-513-0707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. DEBORAH A STEC
Title or Position: OWNER
Credential: PHD
Phone: 262-513-0700