Provider Demographics
NPI:1699130732
Name:JAUER, RHIANNON (PSYD)
Entity type:Individual
Prefix:
First Name:RHIANNON
Middle Name:
Last Name:JAUER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:RHIANNON
Other - Middle Name:
Other - Last Name:MATZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 735044
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5044
Mailing Address - Country:US
Mailing Address - Phone:800-326-2250
Mailing Address - Fax:
Practice Address - Street 1:6980 N PORT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53217-3900
Practice Address - Country:US
Practice Address - Phone:414-773-4312
Practice Address - Fax:414-247-4082
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3326103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100051939Medicaid