Individual
MAUREEN DONAHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-4200
Mailing address
279 S 17TH AVE, #10, WEST BEND, WI 53095-3001
(262) 306-8994
(262) 306-9317
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1782
WI
101YM0800X
Mental Health Counselor
3207-125
WI
101YP2500X
Professional Counselor
Primary
3207-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39353000
—
WI
Enumeration date
10/25/2006
Last updated
02/24/2023
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