Haviland, Jennie Rae

Haviland, Jennie Rae is an sole proprietor health care provider with primary practice located at 3001 Us Highway 12 E Ste 225 , Menomonie WI 54751-3045. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Haviland, Jennie Rae can be contacted via phone (715) 231-2771.

Contact Information

Primary practice address
3001 Us Highway 12 E Ste 225 Menomonie WI 54751-3045
Phone: (715) 231-2771
Fax: (715) 232-5987
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 1074-124 Wisconsin

Profile Details

NPI number 1477858058
LBN Legal business name Haviland, Jennie Rae
Credentials MS LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 13th, 2011
Last updated Mar 14th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477858058 NPPES
Wisconsin MEDICAID 100072751
Wisconsin Other 14135702

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