Elkhart Psychological Services, LLC

NPI #1265554430 in Monona, Wisconsin

Provider Information

NPI Number: 1265554430
Entity Type: Organization
Organization Name: Elkhart Psychological Services, LLC
Primary Specialty: Psychologist - Clinical
Enumeration Date: Apr 6, 2007
Last Updated: Apr 20, 2008

Practice Location

Address: 6000 MONONA DR
Address 2: SUITE 203
City: Monona
State: Wisconsin
ZIP Code: 53716-3931
Phone: (608) 223-9767

Authorized Official

Name: DR. LAWRENCE MANDT, PH.D
Title: OWNER
Phone: (608) 223-9767

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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