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Contact Information

MARILYN E BOHATKIEWICZ, PHD
2200 DICKINSON RD UNIT 4
SUITE B
DE PERE, WI54115-4056
 Phone: 920-347-3500
 Fax: 920-347-3501
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MARILYN E BOHATKIEWICZ · (Female)

NPI Number 1992884159
Status Active
Credentials PHD
Entity Individual
Enumeration date 11/06/2006
Last updated 02/24/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • WI License # 1180057
  • WI Medicaid 39040500
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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