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Individual

CYNTHIA JOAN JURISHICA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
710 N WEBB AVE, REEDSBURG, WI 53959-1149
(608) 524-5151
(608) 524-5353
Mailing address
W5750 FISH CT, MONTELLO, WI 53949-7862
(715) 897-4158

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
2053
WI
1041C0700X
Clinical Social Worker
Primary
2053-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2053-123
SOCIAL WORK LICENSE
WI
Enumeration date
07/23/2018
Last updated
06/07/2024
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