Walos, Jessica

Walos, Jessica is an individual health care provider with primary practice located at 436 Summit Ave , Oconomowoc WI 53066-3749. She recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as her primary health care specialty. Walos, Jessica can be contacted via phone (262) 719-3625.

Contact Information

Primary practice address
436 Summit Ave Oconomowoc WI 53066-3749
Phone: (262) 719-3625
Fax: (262) 567-5560
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X 2656 Wisconsin

Profile Details

NPI number 1942356308
LBN Legal business name Walos, Jessica
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2007
Last updated Jul 30th, 2008 - about 18 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 1942356308 NPPES
Wisconsin MEDICAID 39157700

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