Provider Demographics
NPI:1891803797
Name:GRAMLING, LORRAINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:
Last Name:GRAMLING
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 1:234 W FLORIDA ST
Mailing Address - Street 2:STE 211
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53204-1659
Mailing Address - Country:US
Mailing Address - Phone:262-782-1474
Mailing Address - Fax:262-782-1441
Practice Address - Street 1:20700 WATERTOWN RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-1800
Practice Address - Country:US
Practice Address - Phone:262-782-1474
Practice Address - Fax:262-782-1441
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI802-057103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical