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General NPI Number Information
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NPI Number | 1780310052
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Entity Type | Individual
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Provider Name | JESSICA LAUREN FOLEY PHD
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Gender | Female
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Dates
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Enumeration Date | 07/28/2022
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 13800 W NORTH AVE STE 120
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City | BROOKFIELD
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State | WI
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Zip | 53005-4977
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Country | US
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Telephone | 262-432-6600
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Fax | 262-432-6604
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Provider Business Mailing Address
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Address Line | 13800 W NORTH AVE STE 120
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City | BROOKFIELD
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State | WI
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Zip | 53005-4977
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Country | US
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Telephone | 262-432-6600
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Fax | 262-432-6604
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 4086
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License Number State | WI
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