Wonder, Holly J
Wonder, Holly J is an sole proprietor health care provider with primary practice located at 11518 N Port Washington Rd Ste 202 , Mequon WI 53092-3443. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Wonder, Holly J can be contacted via phone (262) 244-6177.Contact Information
Primary practice address
11518 N Port Washington Rd Ste 202
Mequon WI 53092-3443
Phone: (262) 244-6177
Fax: (262) 299-3040
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 13219 | Texas |
Profile Details
| NPI number | 1790063170 |
|---|---|
| LBN Legal business name | Wonder, Holly J |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 2nd, 2011 |
| Last updated | Apr 15th, 2020 - about 5 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 | 1790063170 | NPPES |
| Wisconsin | MEDICAID | 100098109 |
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