Healthcare Provider Details

I. General information

NPI: 1033027438
Provider Name (Legal Business Name): MIRYAM BERNARD-DONALS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 QUINN DR STE 200
WAUNAKEE WI
53597-2527
US

IV. Provider business mailing address

2121 CENTER AVE APT 2
MADISON WI
53704-5648
US

V. Phone/Fax

Practice location:
  • Phone: 608-683-8188
  • Fax:
Mailing address:
  • Phone:
  • 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: