Hershberger, Mary A

Hershberger, Mary A is an individual health care provider with primary practice located at 10500 N Port Washington Rd , Mequon WI 53092-5585. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Hershberger, Mary A can be contacted via phone (262) 240-0427.

Contact Information

Primary practice address
10500 N Port Washington Rd Mequon WI 53092-5585
Fax: (262) 240-0429
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2055-125 Wisconsin

Profile Details

NPI number 1740346006
LBN Legal business name Hershberger, Mary A
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2006
Last updated Apr 6th, 2010 - about 16 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 1740346006 NPPES
Wisconsin MEDICAID 39225300

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