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General NPI Number Information
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NPI Number | 1336842269
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Entity Type | Individual
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Provider Name | ANDREAS RYDLAND PH.D
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Gender | Male
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Dates
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Enumeration Date | 03/22/2023
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 9809 S FRANKLIN DR STE 302
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City | FRANKLIN
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State | WI
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Zip | 53132-8885
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Country | US
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Telephone | 262-789-1191
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Fax |
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Provider Business Mailing Address
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Address Line | 9809 S FRANKLIN DR STE 302
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City | FRANKLIN
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State | WI
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Zip | 53132-8885
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Country | US
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Telephone |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4012-57
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License Number State | WI
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