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General NPI Number Information
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NPI Number | 1689942393
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Entity Type | Organization
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Legal Business Name | TMS CENTER OF WISCONSIN LLC
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Dates
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Enumeration Date | 12/08/2011
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Last Update Date | 12/08/2011
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Provider Practice Location Address
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Address Line | 2600 N MAYFAIR RD STE 385
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City | WAUWATOSA
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State | WI
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Zip | 53226-1372
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Country | US
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Telephone | 414-251-0671
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Fax | 414-257-3588
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Provider Business Mailing Address
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Address Line | 2600 N MAYFAIR RD STE 385
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City | WAUWATOSA
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State | WI
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Zip | 53226-1372
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Country | US
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Telephone | 414-251-0671
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Fax | 414-257-3588
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Authorized Official
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Title or Position | PSYCHIATRIST/OWNER
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Name | BERNADETTE DEMURI
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Credential | MD
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Telephone | 414-251-0671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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