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General NPI Number Information
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NPI Number | 1609113232
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Entity Type | Organization
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Legal Business Name | JILL R. TURCOTT-NIELSEN, LLC
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Dates
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Enumeration Date | 01/16/2013
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 10625 W NORTH AVE SUITE 225
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City | WAUWATOSA
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State | WI
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Zip | 53226-2315
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Country | US
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Telephone | 414-258-2600
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Fax | 262-796-8112
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Provider Business Mailing Address
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Address Line | 10625 W NORTH AVE SUITE 225
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City | WAUWATOSA
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State | WI
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Zip | 53226-2315
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Country | US
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Telephone | 414-258-2600
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Fax | 262-796-8112
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Authorized Official
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Title or Position | CLINIC OWNER
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Name | MS. JILL R. TURCOTT-NIELSEN
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Credential | LCSW
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Telephone | 414-258-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2573-123
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License Number State | WI
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