Provider Information for 1104863596
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OLIN KIRK YAUCHLER LCSW
Sex: Male
NPI: 1104863596
Last Updated: 2007-12-19
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1104863596 | ||||||||||||
| Enumeration Date | 2006-06-02 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 3011 SAYLESVILLE RD WAUKESHA, WI 53189 United States Phone: 262-928-6900 | Fax:262-928-3815 | ||||||||||||
| Primary Practice Address | 3011 SAYLESVILLE RD WAUKESHA, WI 53189 United States Phone: 262-928-6900 | Fax:262-928-3815 | ||||||||||||
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