James Jeffrey Crisco
Clinical Child & Adolescent Psychologist
3636 N 124th St Suite 200
Wauwatosa
, Wisconsin 53222-2125
James Jeffrey Crisco
Clinical Child & Adolescent Psychologist
3636 N 124th St Suite 200
Wauwatosa
, Wisconsin 53222-2125
(414) 476-3413
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About
Features
Specialties
- Clinical Child & Adolescent Psychologist
Languages spoken
- English
Location
First Address
- James Jeffrey Crisco
- 3636 N 124th St Suite 200
- Wauwatosa, WI
- Zip : 53222-2125
- Fax : (414) 476-3413
- Phone : (414) 476-9755
Second Address
- James Jeffrey Crisco
- 3636 N 124th St Suite 200
- Wauwatosa, WI
- Zip : 53222-2125
- Fax : (414) 476-3413
- Phone : (414) 476-9755
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 613-057 | WI |
National Provider Identifier
| NPI | 1013172600 |
|---|---|
| Provider Name | James Jeffrey Crisco |
| First Address | Wauwatosa, WI 53222-2125 |
| Second Address | Wauwatosa, WI 53222-2125 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/07/2008 |
| Last Update Date | 22/04/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 39010900 | (05) | WI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.