Provider Demographics
NPI:1164749362
Name:ADVANCED HEARING SOLUTIONS OF WISCONSIN SC
Entity Type:Organization
Organization Name:ADVANCED HEARING SOLUTIONS OF WISCONSIN SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATE
Authorized Official - Middle Name:M
Authorized Official - Last Name:OLSEN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:262-784-9300
Mailing Address - Street 1:12780 W NORTH AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-4601
Mailing Address - Country:US
Mailing Address - Phone:262-784-9300
Mailing Address - Fax:262-784-9306
Practice Address - Street 1:12780 W NORTH AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4601
Practice Address - Country:US
Practice Address - Phone:262-784-9300
Practice Address - Fax:262-784-9306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI35-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty