Provider Information for 1578706750
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Mrs. JO ANN MARTHA MCCLURE MS, TLPC
Sex: Female
NPI: 1578706750
Last Updated: 2009-04-17
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1578706750 | ||||||||
| Enumeration Date | 2009-04-17 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2600 N MAYFAIR RD SUITE 650 WAUWATOSA, WI 53226-1309 United States Phone: 414-771-9304 | Fax:414-771-9543 | ||||||||
| Primary Practice Address | 2600 N MAYFAIR RD SUITE 650 WAUWATOSA, WI 53226-1309 United States Phone: 414-771-9304 | Fax:414-771-9543 | ||||||||
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