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General NPI Number Information
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NPI Number | 1821153594
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Entity Type | Organization
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Legal Business Name | TIM CAUFIELD, PHD LLC
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Dates
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Enumeration Date | 12/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 484 N PINE ST
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City | BURLINGTON
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State | WI
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Zip | 53105-1417
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Country | US
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Telephone | 262-492-6479
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Fax |
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Provider Business Mailing Address
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Address Line | 484 N PINE ST
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City | BURLINGTON
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State | WI
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Zip | 53105-1417
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Country | US
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Telephone | 262-492-6479
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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. TIMOTHY GEORGE CAUFIELD
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Credential | PH.D.
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Telephone | 262-492-6479
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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 | 1329
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License Number State | WI
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