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General NPI Number Information
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NPI Number | 1821495185
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Entity Type | Organization
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Legal Business Name | INSIDE/OUT CLINICAL PSYCHOLOGY SERVICES, LLC
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 102 W STATE ST
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City | MAUSTON
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State | WI
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Zip | 53948-1354
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Country | US
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Telephone | 608-847-7924
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Fax | 608-847-7925
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Provider Business Mailing Address
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Address Line | PO BOX 193
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City | MAUSTON
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State | WI
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Zip | 53948-0193
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Country | US
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Telephone | 608-847-7924
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Fax | 608-847-7925
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARGARET A. DENNISON
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Credential | PH.D.
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Telephone | 608-847-7924
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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 | 2394-57
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License Number State | WI
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