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Provider Information for 1780892026


The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.

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Dr. MARTY SAPP Ed.D.


Sex: Male

NPI: 1780892026
Last Updated: 2007-07-08
Certification Date:

Details

NameValue
NPI1780892026
Enumeration Date2007-05-18
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 6110 N PORT WASHINGTON RD
GLENDALE, WI 53217-4308
United States

Phone: 414-229-6347 | Fax:414-229-4939
 
Primary Practice Address 6110 N PORT WASHINGTON RD
GLENDALE, WI 53217-4308
United States

Phone: 414-229-6347 | Fax:414-229-4939
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 103TB0200X - Psychologist - Cognitive & BehavioralWI1404-057