Doctor Name: | JAMES K GERNDT |
NPI Number: | 1174544746 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 1249-057 |
Business Practice Address: | 6300 University Ave Suite 25 Middleton, WI - 535623463 |
Business Phone Number: | 6082378000 |
Business Fax Number: | 6082378005 |
Mailing Address: | 6300 University Ave, Suite 25 MIDDLETON |
State: | WI |
Postal Code: | 535623463 |
Phone Number: | 6082378000 |
Fax Number: | 6082378005 |
NPI Enumeration Date: | 07/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1249-057 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |