Provider Demographics
NPI:1982874525
Name:BARTELL, IRENE P (PHD)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:P
Last Name:BARTELL
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 1:6418 NORMANDY LN
Mailing Address - Street 2:SUITE 215
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1149
Mailing Address - Country:US
Mailing Address - Phone:608-274-1900
Mailing Address - Fax:608-271-0502
Practice Address - Street 1:6418 NORMANDY LN
Practice Address - Street 2:SUITE 215
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1149
Practice Address - Country:US
Practice Address - Phone:608-274-1900
Practice Address - Fax:608-271-0502
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1739 057103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral