Phouybanhdyt, Hinhpalom A
Phouybanhdyt, Hinhpalom A is an sole proprietor health care provider with primary practice located at 3015 N 114Th St , Wauwatosa WI 53222-4208. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Phouybanhdyt, Hinhpalom A can be contacted via phone (414) 431-4444.Contact Information
Primary practice address
3015 N 114Th St
Wauwatosa WI 53222-4208
Phone: (414) 431-4444
Fax: (414) 431-0858
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 43721700 | Wisconsin |
Profile Details
| NPI number | 1063685634 |
|---|---|
| LBN Legal business name | Phouybanhdyt, Hinhpalom A |
| Credentials | M.S. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 3rd, 2008 |
| Last updated | Apr 3rd, 2008 - about 16 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 | 1063685634 | NPPES |
| Wisconsin | MEDICAID | 43721700 |
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