Provider Demographics
NPI:1770749269
Name:MCGRATH WETJEN, CHRISTINE ANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ANNE
Last Name:MCGRATH WETJEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ANN
Other - Last Name:MCGRATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 MERCY DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-7303
Mailing Address - Country:US
Mailing Address - Phone:563-584-3500
Mailing Address - Fax:563-584-3520
Practice Address - Street 1:200 MERCY DR
Practice Address - Street 2:SUITE 201
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-7303
Practice Address - Country:US
Practice Address - Phone:563-584-3500
Practice Address - Fax:563-584-3520
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001234103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist