Individual
MEGAN J DEMIANIUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
4351 W COLLEGE AVE STE 410, APPLETON, WI 54914-3928
(800) 438-1772
(262) 345-5562
Mailing address
W175N11120 STONEWOOD DR, GERMANTOWN, WI 53022-6511
(262) 345-5560
(262) 345-5531
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
819-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679725972
—
WI
Enumeration date
10/17/2008
Last updated
10/26/2021
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