NPI 1073030961

Jonathan James Mietchen, TLMLP

Practitioner Clinical Neuropsychologist Madison, WI

Practice location

Address: 600 Highland Ave, Madison, WI 53792-9469
Phone: (608) 263-5430
Mailing address: 7974 Uw Health CT, Middleton, WI 53562-5531

Registered specialties (2)

Clinical Neuropsychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103G00000X Licence 3815-57 (WI)

Other Clinical Neuropsychologist providers in Wisconsin →

Clinical Psychologist

Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence 2795 (KS)

Other Psychologist providers in Wisconsin →

Registry record

NPI: 1073030961
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Aug 2017
Record last updated: 8 Feb 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.