Lakeshore Psychology Services LLC

NPI #1518459411 in Mequon, Wisconsin

Provider Information

NPI Number: 1518459411
Entity Type: Organization
Organization Name: Lakeshore Psychology Services LLC
Primary Specialty: Psychologist
Enumeration Date: Jun 6, 2018
Last Updated: Jun 6, 2018

Practice Location

Address: 1045 W GLEN OAKS LN STE 205
City: Mequon
State: Wisconsin
ZIP Code: 53092
Phone: (414) 235-0431

Authorized Official

Name: DR. LEE EDWARD HILDEBRAND, PSYCHOLOGIST
Title: DIRECTOR
Phone: (414) 235-0431

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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