Provider Demographics
NPI:1669489167
Name:LAWRENCE, ANN CONNOR (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:CONNOR
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12900 LEE CT
Mailing Address - Street 2:
Mailing Address - City:ELM GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53122-1444
Mailing Address - Country:US
Mailing Address - Phone:414-431-3344
Mailing Address - Fax:414-434-1950
Practice Address - Street 1:12900 LEE CT
Practice Address - Street 2:
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-1444
Practice Address - Country:US
Practice Address - Phone:414-431-3344
Practice Address - Fax:414-434-1950
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2023-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2103-57103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical