Provider Demographics
NPI:1093211294
Name:STENEHJEM, JOLYNN (LMT)
Entity Type:Individual
Prefix:
First Name:JOLYNN
Middle Name:
Last Name:STENEHJEM
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 CRAIG AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-1335
Mailing Address - Country:US
Mailing Address - Phone:608-658-4329
Mailing Address - Fax:
Practice Address - Street 1:2605 BRANCH ST
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-2203
Practice Address - Country:US
Practice Address - Phone:608-658-4329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3280-146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty