Provider Demographics
NPI:1902452949
Name:WILHELMI, TARA H (CPSS)
Entity Type:Individual
Prefix:MS
First Name:TARA
Middle Name:H
Last Name:WILHELMI
Suffix:
Gender:F
Credentials:CPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6417 ODANA RD.
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719
Mailing Address - Country:US
Mailing Address - Phone:608-268-6530
Mailing Address - Fax:608-709-1744
Practice Address - Street 1:6417 ODANA RD.
Practice Address - Street 2:SUITE 5
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719
Practice Address - Country:US
Practice Address - Phone:608-268-6530
Practice Address - Fax:608-709-1744
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist