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General NPI Number Information
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NPI Number | 1487866455
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Entity Type | Individual
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Provider Name | ALLYSON R. ENDE PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 227500 RIB MOUNTAIN DR STE 103
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City | WAUSAU
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State | WI
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Zip | 54401-5052
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Country | US
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Telephone | 715-348-2828
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Fax |
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Provider Business Mailing Address
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Address Line | 1720 HIGHWOOD LN
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City | WAUSAU
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State | WI
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Zip | 54403-8131
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Country | US
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Telephone | 715-574-4805
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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 | 071.006207
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3264
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License Number State | WI
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