Enderlin, Mary Catherine

Enderlin, Mary Catherine is an individual health care provider with primary practice located at 6110 N Port Washington Road The Cambridge Group, Glendale WI 53217. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Enderlin, Mary Catherine can be contacted via phone (414) 332-7400.

Contact Information

Primary practice address
6110 N Port Washington Road The Cambridge Group Glendale WI 53217
Fax: (414) 963-6866
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2247 057 Wisconsin

Profile Details

NPI number 1164625455
LBN Legal business name Enderlin, Mary Catherine
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164625455 NPPES
Wisconsin MEDICAID 39765000

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