Provider Demographics
NPI:1154432144
Name:GERWOOD, JOSEPH B (PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:B
Last Name:GERWOOD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 PRENTICE ST N
Mailing Address - Street 2:P. O. BOX 8004
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-1162
Mailing Address - Country:US
Mailing Address - Phone:715-344-4611
Mailing Address - Fax:715-344-8127
Practice Address - Street 1:209 PRENTICE ST N
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-1162
Practice Address - Country:US
Practice Address - Phone:715-344-4611
Practice Address - Fax:715-344-8127
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2161-057103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist