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NPI Code Detail

MEDICARE: MS. MARIE-THERESE HELLRUNG MS, LMFT

MEDICARE:  MS. MARIE-THERESE  HELLRUNG  MS, LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist740-124WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184797532
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARIE-THERESE HELLRUNG MS, LMFT
Provider Business Mailing Address
First Line : 7031 N ARDARA AVE
Second Line :
City : GLENDALE
State : WI
Zip : 53209-2921
Country : US
Telephone Number : 414-899-7996
Fax Number :
Provider Business Practice Location Address
First Line : 5555 N PORT WASHINGTON RD STE 200
Second Line : SUITE 100
City : GLENDALE
State : WI
Zip : 53217-4927
Country : US
Telephone Number : 262-789-1191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2006
Last Update Date : 01/31/2022

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