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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972592095 NPPES
Wisconsin MEDICAID 40938800

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