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General NPI Number Information
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NPI Number | 1417426925
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Entity Type | Individual
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Provider Name | EDWARD DOW PH.D.
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Gender | Male
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 1433 N WATER ST 4TH FLOOR
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City | MILWAUKEE
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State | WI
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Zip | 53202
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Country | US
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Telephone | 917-719-4385
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Fax |
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Provider Business Mailing Address
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Address Line | 2108A SILVERNAIL RD STE 103
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City | PEWAUKEE
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State | WI
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Zip | 53072-5526
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Country | US
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Telephone | 262-229-9343
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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 | 2042-57
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License Number State | WI
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