| Tammy Giannopoulos, Llc | |
|
4402 S 68th St Suite 100 Greenfield WI 53220 | |
| (414) 331-8167 | |
| (414) 321-0552 |
| Full Name | Tammy Giannopoulos, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4402 S 68th St Suite 100, Greenfield, Wisconsin |
| Authorized Official Name and Position | Tammy Giannopoulos (PSYCHOTHERAPIST) |
| Authorized Official Contact | 4143318167 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tammy Giannopoulos, Llc 4402 S 68th St Suite 100 Greenfield WI 53220 Ph: (414) 331-8167 | Tammy Giannopoulos, Llc 4402 S 68th St Suite 100 Greenfield WI 53220 Ph: (414) 331-8167 |
| NPI Number | 1295139012 |
|---|---|
| Provider Enumeration Date | 10/22/2014 |
| Last Update Date | 10/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295139012 | NPI | - | NPPES |
| 100016425 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 7779-123 (Wisconsin) | Primary |
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