| Organization Name: | DEMENTIA CONSULTATIONS LLC |
| NPI Number: | 1417123092 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHILOMENA MAE POOLE (NURSE PRACTITIONER, SOLE PROPRIETER) |
| Mailing Address: | 265 North Park Street Richland Center |
| State: | WI US |
| Postal Code: | 535812208 |
| Phone Number: | 6086476538 |
| Fax Number: | |
| NPI Enumeration Date: | 05/05/2008 |
| NPI Last Update Date: | 05/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | 964-033 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |