Pahlavan, Jody Ann

Pahlavan, Jody Ann is an sole proprietor health care provider with primary practice located at 11101 W Lincoln Ave Rogers Memorial Hospital, West Allis WI 53227-1133. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Pahlavan, Jody Ann can be contacted via phone (414) 327-3000.

Contact Information

Primary practice address
11101 W Lincoln Ave Rogers Memorial Hospital West Allis WI 53227-1133
Phone: (414) 327-3000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1694-057 Wisconsin

Profile Details

NPI number 1093707044
LBN Legal business name Pahlavan, Jody Ann
Credentials PSYD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 16th, 2005
Last updated Aug 25th, 2017 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093707044 NPPES
Wisconsin MEDICAID 39229700

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