| Modern Wellness Llc | |
|
S73w16485 Janesville Rd Ste 202 Muskego WI 53150-8960 | |
| (262) 221-0369 | |
| Not Available |
| Full Name | Modern Wellness Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | S73w16485 Janesville Rd Ste 202, Muskego, Wisconsin |
| Authorized Official Name and Position | Jessica Shaw (LPC) |
| Authorized Official Contact | 2622210369 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Wellness Llc S73w16485 Janesville Rd Ste 202 Muskego WI 53150-8960 Ph: (262) 221-0369 | Modern Wellness Llc S73w16485 Janesville Rd Ste 202 Muskego WI 53150-8960 Ph: (262) 221-0369 |
| NPI Number | 1831951300 |
|---|---|
| Provider Enumeration Date | 01/29/2024 |
| Last Update Date | 02/09/2024 |
| Certification Date | 02/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831951300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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