Male or Other

Dr. Charles M. Lodl PH.D.

Psychologist in Mequon, WI(View on Map)

Full Name

Dr. Charles Mathew Lodl PH.D.

NPI Number

1033132899

NPI Type

Individual Provider

Gender

Male

Enumeration Date

07/25/2006

Specialties

(Taxonomies)

Code

103T00000X

Primary Taxonomy

Yes

Licenses

State

Wisconsin

License Number

857-057

Contact
Information

Purpose

Mailing
Location

Address

11501 N PORT WASHINGTON RD
11501 N PORT WASHINGTON RD

City

Mequon
Mequon

State

WI
WI

Postal Code

53092-3466
53092-3466

Country

US
US

Telephone Number

(262) 241-8901
(262) 241-8901

Identifiers

Identifier

39050600

Identifier State

WI

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address

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