Healthcare Provider Details

I. General information

NPI: 1790609287
Provider Name (Legal Business Name): MAUREEN VILLARS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 N 60TH ST
MILWAUKEE WI
53208-2153
US

IV. Provider business mailing address

307 N TERRACE ST
JANESVILLE WI
53548-3654
US

V. Phone/Fax

Practice location:
  • Phone: 608-607-2141
  • Fax:
Mailing address:
  • Phone: 608-607-2141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: