Provider Demographics
NPI:1568569705
Name:VRANIAK, DAMIAN A (PHD)
Entity Type:Individual
Prefix:
First Name:DAMIAN
Middle Name:A
Last Name:VRANIAK
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:W3177 HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGBROOK
Mailing Address - State:WI
Mailing Address - Zip Code:54875-9314
Mailing Address - Country:US
Mailing Address - Phone:715-766-2045
Mailing Address - Fax:
Practice Address - Street 1:W3177 HAMILTON RD
Practice Address - Street 2:
Practice Address - City:SPRINGBROOK
Practice Address - State:WI
Practice Address - Zip Code:54875-9314
Practice Address - Country:US
Practice Address - Phone:715-766-2045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI885103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist