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General NPI Number Information
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NPI Number | 1306217492
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Entity Type | Individual
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Provider Name | PAUL FLORSHEIM PHD
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Gender | Male
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Dates
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Enumeration Date | 10/14/2015
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Last Update Date | 10/14/2015
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Provider Practice Location Address
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Address Line | 4105 N FARWELL AVE
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City | MILWAUKEE
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State | WI
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Zip | 53211-1754
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Country | US
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Telephone | 801-949-7389
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Fax |
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Provider Business Mailing Address
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Address Line | 4105 N FARWELL AVE
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City | MILWAUKEE
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State | WI
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Zip | 53211-1754
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Country | US
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Telephone | 801-949-7389
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2885
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 2885
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License Number State | WI
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