Individual
JERRY W HALSTEN
Active
Individual
JERRY W HALSTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1820-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39105900
—
WI
01
—
7310
DEAN HEALTH INSURANCE
WI
Enumeration date
04/26/2006
Last updated
03/11/2021
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