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General NPI Number Information
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NPI Number | 1184332280
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Entity Type | Organization
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Legal Business Name | PSYCHOSOCIAL SERVICES LLC
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Dates
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Enumeration Date | 11/08/2022
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Last Update Date | 02/21/2023
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Provider Practice Location Address
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Address Line | 1661 N WATER ST STE 308
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City | MILWAUKEE
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State | WI
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Zip | 53202-2086
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Country | US
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Telephone | 906-396-1040
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Fax |
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Provider Business Mailing Address
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Address Line | 1661 N WATER ST STE 308
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City | MILWAUKEE
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State | WI
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Zip | 53202-2086
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Country | US
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Telephone | 906-396-1040
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAMANTHA HURKMANS
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Credential | PSY
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Telephone | 906-396-1040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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