Provider Demographics
NPI:1194271874
Name:BARBARA C SIECK LLC
Entity type:Organization
Organization Name:BARBARA C SIECK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIECK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:262-899-2106
Mailing Address - Street 1:325 FOREST GROVE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-3894
Mailing Address - Country:US
Mailing Address - Phone:262-899-2106
Mailing Address - Fax:
Practice Address - Street 1:325 FOREST GROVE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-3894
Practice Address - Country:US
Practice Address - Phone:262-899-2106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty