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General NPI Number Information
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NPI Number | 1760649354
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Entity Type | Organization
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Legal Business Name | RICHARD A HOHFELER III PSYD, S.C.
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 10045 W LISBON AVE
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City | WAUWATOSA
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State | WI
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Zip | 53222-2446
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Country | US
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Telephone | 414-351-7151
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Fax | 414-393-1640
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Provider Business Mailing Address
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Address Line | 4329 N SAWYER RD
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City | OCONOMOWOC
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State | WI
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Zip | 53066-4551
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Country | US
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Telephone | 262-569-8399
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD AUGUST HOHFELER III
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Credential | PSYD
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Telephone | 262-569-8399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1295
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License Number State | WI
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