Koop Olsta, Jennifer I
Koop Olsta, Jennifer I is an individual health care provider with primary practice located at 9000 W Wisconsin Ave , Milwaukee WI 53226-4874. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as her primary health care specialty. Koop Olsta, Jennifer I can be contacted via phone (414) 955-0660.Contact Information
Primary practice address
9000 W Wisconsin Ave
Milwaukee WI 53226-4874
Phone: (414) 955-0660
Fax: (414) 955-0076
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 2558 | Wisconsin |
Profile Details
| NPI number | 1053362897 |
|---|---|
| LBN Legal business name | Koop Olsta, Jennifer I |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 15th, 2006 |
| Last updated | May 2nd, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053362897 | NPPES |
| Wisconsin | MEDICAID | 39149800 | |
| Wisconsin | MEDICAID | 1053362897 |
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