| Doctor Name: | DR. CRAIG D. CHILDS |
| NPI Number: | 1285960518 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | 2834-057 |
| Business Practice Address: | 394 Williamstowne Suite 202 Delafield, WI - 530182322 |
| Business Phone Number: | 2626466404 |
| Business Fax Number: | 2626466405 |
| Mailing Address: | 394 Williamstowne, Suite 202 DELAFIELD |
| State: | WI |
| Postal Code: | 530182322 |
| Phone Number: | 2626466404 |
| Fax Number: | 2626466405 |
| NPI Enumeration Date: | 10/21/2009 |
| NPI Last Update Date: | 06/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 05/28/2013 |
| NPI Reactivation Date: | 06/20/2013 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TA0400X |
| License Number: | 2834-057 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |