Rudman, Jill C.

Rudman, Jill C. is an sole proprietor health care provider with primary practice located at 2665 S Moorland Rd Suite 100, New Berlin WI 53151. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Rudman, Jill C. can be contacted via phone (414) 475-1896.

Contact Information

Primary practice address
2665 S Moorland Rd Suite 100 New Berlin WI 53151
Phone: (414) 475-1896
Fax: (414) 988-9764
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2172-057 Wisconsin
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1095559 Wisconsin

Profile Details

NPI number 1912041096
LBN Legal business name Rudman, Jill C.
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 20th, 2007
Last updated Sep 5th, 2018 - about 7 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 1912041096 NPPES
Wisconsin MEDICAID 39679600

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