| Jodi Brin Psychological Services Llc | |
|
14135 N Cedarburg Rd Mequon WI 53097-1416 | |
| (262) 377-2006 | |
| Not Available |
| Full Name | Jodi Brin Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 14135 N Cedarburg Rd, Mequon, Wisconsin |
| Authorized Official Name and Position | Jodi Allison Brin (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2622366693 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jodi Brin Psychological Services Llc 12616 N Saint Anne Ln Mequon WI 53092-2263 Ph: (262) 236-6693 | Jodi Brin Psychological Services Llc 14135 N Cedarburg Rd Mequon WI 53097-1416 Ph: (262) 377-2006 |
| NPI Number | 1134577133 |
|---|---|
| Provider Enumeration Date | 05/31/2016 |
| Last Update Date | 07/28/2016 |
| Medicare PECOS PAC ID | 0547553950 |
|---|---|
| Medicare Enrollment ID | O20160722000977 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134577133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 3346-57 (Wisconsin) | Primary |
| Provider Name | Jodi Allison Brin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629426200 PECOS PAC ID: 1456644863 Enrollment ID: I20160722001218 |
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