| Krista Demuth Llc | |
|
815 Davis St Hammond WI 54015-9808 | |
| (612) 567-9881 | |
| Not Available |
| Full Name | Krista Demuth Llc |
|---|---|
| Speciality | Counselor |
| Location | 815 Davis St, Hammond, Wisconsin |
| Authorized Official Name and Position | Krista J Demuth (OWNER) |
| Authorized Official Contact | 7154101280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Krista Demuth Llc 625 Klein Dr Hammond WI 54015-9798 Ph: (715) 410-1280 | Krista Demuth Llc 815 Davis St Hammond WI 54015-9808 Ph: (612) 567-9881 |
| NPI Number | 1891436366 |
|---|---|
| Provider Enumeration Date | 04/06/2022 |
| Last Update Date | 08/27/2022 |
| Certification Date | 08/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891436366 | NPI | - | NPPES |
| 1083085914 | Medicaid | WI | |
| 100059323 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
Cdl Psychological Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Johnson Pkwy, Hammond, WI 54015 Phone: 715-497-7230 Fax: 715-600-9041 |