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General NPI Number Information
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NPI Number | 1518104074
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Entity Type | Organization
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Legal Business Name | DR STRESS & ASSOCIATES LLC
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Dates
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Enumeration Date | 01/20/2009
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Last Update Date | 06/08/2009
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Provider Practice Location Address
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Address Line | 1030 OAK RIDGE DR
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4564
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Country | US
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Telephone | 715-833-7111
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Fax | 715-833-0454
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Provider Business Mailing Address
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Address Line | 1030 OAK RIDGE DR
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4564
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Country | US
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Telephone | 715-833-7111
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Fax | 715-833-0454
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN STRESS
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Credential | PSYD
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Telephone | 715-833-7111
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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 | 2419-57
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License Number State | WI
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