Fancher, Maejeanne
Fancher, Maejeanne is an individual health care provider with primary practice located at 416 W South St , Oconomowoc WI 53066-2755. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Fancher, Maejeanne can be contacted via phone (262) 567-7673.Contact Information
Primary practice address
416 W South St
Oconomowoc WI 53066-2755
Phone: (262) 567-7673
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X |
Profile Details
| NPI number | 1972592095 |
|---|---|
| LBN Legal business name | Fancher, Maejeanne |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 20th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972592095 | NPPES |
| Wisconsin | MEDICAID | 40938800 |
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