Healthcare Provider Details

I. General information

NPI: 1184900607
Provider Name (Legal Business Name): SHAUNA PUTZY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHAUNA HILLER BEHAVIOR ANALYST

II. Dates (important events)

Enumeration Date: 10/28/2011
Last Update Date: 08/25/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 W CLAIREMONT AVE STE 6
EAU CLAIRE WI
54701
US

IV. Provider business mailing address

1324 W CLAIREMONT AVE STE 6
EAU CLAIRE WI
54701
US

V. Phone/Fax

Practice location:
  • Phone: 715-895-7115
  • Fax: 715-836-0065
Mailing address:
  • Phone: 715-895-7115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5709-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: