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General NPI Number Information
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NPI Number | 1245245794
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Entity Type | Organization
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Legal Business Name | A NEW DAY PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 970 S SILVER LAKE ST SUITE 103
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City | OCONOMOWOC
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State | WI
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Zip | 53066-3802
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Country | US
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Telephone | 262-567-7900
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Fax | 262-567-7908
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Provider Business Mailing Address
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Address Line | 970 S SILVER LAKE ST SUITE 103
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City | OCONOMOWOC
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State | WI
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Zip | 53066-3802
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Country | US
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Telephone | 262-567-7900
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Fax | 262-567-7908
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Authorized Official
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Title or Position | OWNER
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Name | BONITA JEAN DEBBAN
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Credential | PH.D.
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Telephone | 262-567-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2324-057
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License Number State | WI
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