Healthcare Provider Details

I. General information

NPI: 1528152022
Provider Name (Legal Business Name): DONNA MARIE JULEFF M.S., MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 E PROSPECT ST
DURAND WI
54736-1517
US

IV. Provider business mailing address

1316 E PROSPECT ST
DURAND WI
54736-1517
US

V. Phone/Fax

Practice location:
  • Phone: 715-495-8396
  • Fax: 608-268-9824
Mailing address:
  • Phone: 715-495-8396
  • Fax: 608-268-9824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number684124
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number684-124
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: