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General NPI Number Information
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NPI Number | 1881406593
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Entity Type | Organization
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Legal Business Name | WISCONSIN INSTITUTE FOR LEARNING DISABILITIES/DYSLEXIA INC.
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 811 E WASHINGTON AVE STE 400
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City | MADISON
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State | WI
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Zip | 53703-4028
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Country | US
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Telephone | 608-371-9602
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Fax |
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Provider Business Mailing Address
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Address Line | 811 E WASHINGTON AVE STE 400
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City | MADISON
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State | WI
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Zip | 53703-4028
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Country | US
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Telephone | 608-371-9602
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ERVIN ALLEN CARPENTER
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Credential |
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Telephone | 608-371-9621
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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 |
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License Number State |
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