Individual
MS. JO M WEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1155 NORTH MAYFAIR ROAD, BEHAVIORAL HEALTH CLINIC @ TOSA, MILWAUKEE, WI 53226
(414) 955-8900
(414) 955-6285
Mailing address
1155 N MAYFAIR RD, BEHAVIORAL HEALTH CLINIC @ TOSA, MILWAUKEE, WI 53226-3421
(414) 955-8900
(414) 955-6285
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
2245
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004006261J
HUMANA
—
05
—
1841242294
—
WI
Enumeration date
05/16/2006
Last updated
09/26/2014
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