Tetkoski, Michael
Tetkoski, Michael is an individual health care provider with primary practice located at 1312 W Towne Square Rd , Mequon WI 53092-5046. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Tetkoski, Michael can be contacted via phone (262) 241-5099.Contact Information
Primary practice address
1312 W Towne Square Rd
Mequon WI 53092-5046
Phone: (262) 241-5099
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 1098-057 | Wisconsin |
Profile Details
| NPI number | 1316994676 |
|---|---|
| LBN Legal business name | Tetkoski, Michael |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 30th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1316994676 | NPPES |
| Wisconsin | MEDICAID | 39036200 |
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