Kaddatz, Terry R

Kaddatz, Terry R is an individual health care provider with primary practice located at 3398 East Maria Drive , Stevens Point WI 54481. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Kaddatz, Terry R can be contacted via phone (715) 341-7441.

Contact Information

Primary practice address
3398 East Maria Drive Stevens Point WI 54481
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2013 Wisconsin

Profile Details

NPI number 1972648251
LBN Legal business name Kaddatz, Terry R
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2007
Last updated May 23rd, 2008 - about 17 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 1972648251 NPPES
Wisconsin MEDICAID 39119200

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