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General NPI Number Information
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NPI Number | 1487676474
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Entity Type | Individual
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Provider Name | JEAN ANN WARRIOR PH D
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 1118 PROFESSIONAL DR
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City | DODGEVILLE
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State | WI
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Zip | 53533-1176
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Country | US
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Telephone | 608-935-2838
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Fax | 608-935-9227
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Provider Business Mailing Address
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Address Line | 1118 PROFESSIONAL DR
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City | DODGEVILLE
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State | WI
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Zip | 53533-1176
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Country | US
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Telephone | 608-935-2838
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Fax | 608-935-9227
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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 | 1165057
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License Number State | WI
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