Provider Demographics
NPI:1245568948
Name:NOFFSINGER, JAMIE A (PSYD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:A
Last Name:NOFFSINGER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3158 MIRKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:FRANKSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53126-9325
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5000 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53295-4480
Practice Address - Country:US
Practice Address - Phone:847-293-5319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2014-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2827-57103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical