Stutzman, Phillip
Stutzman, Phillip is an sole proprietor health care provider with primary practice located at 4125 N 124Th St Ste A , Brookfield WI 53005-1837. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Stutzman, Phillip can be contacted via phone (414) 763-2341.Contact Information
Primary practice address
4125 N 124Th St Ste A
Brookfield WI 53005-1837
Phone: (414) 763-2341
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | 201-140 | Wisconsin |
Profile Details
| NPI number | 1124533914 |
|---|---|
| LBN Legal business name | Stutzman, Phillip |
| Credentials | BCBA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 3rd, 2017 |
| Last updated | Dec 3rd, 2017 - about 8 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 | 1124533914 | NPPES |
| Wisconsin | MEDICAID | 100050272 |
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