Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 2681-57 | WI |
Y | 103T00000X | Psychologist | 2681-57 | WI |
NPI | 1003944737 |
---|---|
Provider Name | Jean A Muerhoff-Schweda |
First Address | Brookfield, WI 53045-2737 |
Second Address | Wauwatosa, WI 53213-2504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 21/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43566000 | (05) | WI |