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General NPI Number Information
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NPI Number | 1639145394
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Entity Type | Individual
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Provider Name | ANN L ATHORP-KRECH PHD
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Gender | Female
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 50 S MADISON AVE STE 3
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City | STURGEON BAY
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State | WI
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Zip | 54235-2742
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Country | US
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Telephone | 920-743-4428
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Fax | 920-743-4681
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Provider Business Mailing Address
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Address Line | PO BOX 321
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City | STURGEON BAY
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State | WI
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Zip | 54235-0321
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Country | US
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Telephone | 920-562-8527
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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 | 2516-057
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License Number State | WI
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