Tarvid, Sally Sue
Tarvid, Sally Sue is an sole proprietor health care provider with primary practice located at 740 Pilgrim Pkwy Suite 103, Elm Grove WI 53122-2067. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Tarvid, Sally Sue can be contacted via phone (414) 491-0377.Contact Information
Primary practice address
740 Pilgrim Pkwy Suite 103
Elm Grove WI 53122-2067
Phone: (414) 491-0377
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 7099123 | Wisconsin |
Profile Details
| NPI number | 1962500769 |
|---|---|
| LBN Legal business name | Tarvid, Sally Sue |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Jan 28th, 2016 - about 10 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 | 1962500769 | NPPES |
| Wisconsin | MEDICAID | 40967200 |
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