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General NPI Number Information
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NPI Number | 1659387009
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Entity Type | Organization
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Legal Business Name | WKM PSYCHOLOGY CLINICS, INC.
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6058 S CHESTNUT ST SUITE 100
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City | PLATTEVILLE
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State | WI
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Zip | 53818-8947
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Country | US
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Telephone | 608-342-4853
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Fax | 608-342-4810
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Provider Business Mailing Address
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Address Line | 6058 S CHESTNUT ST SUITE 100
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City | PLATTEVILLE
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State | WI
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Zip | 53818-8947
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Country | US
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Telephone | 608-342-4853
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Fax | 608-342-4810
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. WILLIAM KENT MILLER
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Credential | ED.D.
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Telephone | 608-342-4853
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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 | 864
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License Number State | WI
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