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General NPI Number Information
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NPI Number | 1922173418
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Entity Type | Organization
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Legal Business Name | ELMERGREEN ASSOCIATES,LLC
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 114 GRAND AVENUE
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City | WAUSAU
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State | WI
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Zip | 54403
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Country | US
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Telephone | 715-845-7175
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Fax | 715-845-7142
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Provider Business Mailing Address
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Address Line | 114 GRAND AVENUE
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City | WAUSAU
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State | WI
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Zip | 54403
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Country | US
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Telephone | 715-845-7175
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Fax | 715-845-7142
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | DENNIS DEAN ELMERGREEN
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Credential | PSY.D.
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Telephone | 715-551-7175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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