Wakely, David J.

Wakely, David J. is an individual health care provider with primary practice located at 557 N Washington St , Janesville WI 53548. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Wakely, David J. can be contacted via phone (608) 754-6000.

Contact Information

Primary practice address
557 N Washington St Janesville WI 53548
Phone: (608) 754-6000
Fax: (608) 755-7892
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071-002790 Illinois
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2711-057 Wisconsin

Profile Details

NPI number 1134228802
LBN Legal business name Wakely, David J.
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2006
Last updated Jun 14th, 2018 - about 7 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 1134228802 NPPES
Wisconsin MEDICAID 1134228802
Wisconsin Other P00684638CD3624
Wisconsin Other 541760589
Wisconsin Other WAKELDAV

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