Kupst, Mary Jo
Kupst, Mary Jo is an individual health care provider with primary practice located at 9000 West Wisconsin Ave Children'S Hospital Of Wisconsin, Milwaukee WI 53226. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Kupst, Mary Jo can be contacted via phone (414) 805-3666.Contact Information
Primary practice address
9000 West Wisconsin Ave Children'S Hospital Of Wisconsin
Milwaukee WI 53226
Phone: (414) 805-3666
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 1479 | Wisconsin |
Profile Details
| NPI number | 1124079967 |
|---|---|
| LBN Legal business name | Kupst, Mary Jo |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 15th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1124079967 | NPPES |
| Wisconsin | MEDICAID | 39082000 |
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