Individual
MS. JILL WALTER MAXEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LPC
Contact information
Practice address
901 N. 6TH STREET, WAUSAU, WI 54403-4718
(715) 848-5022
(888) 778-6750
Mailing address
901 N. 6TH STREET, WAUSAU, WI 54403-4718
(715) 848-5022
(888) 778-6750
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2778-125
WI
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40922500
—
WI
Enumeration date
03/28/2007
Last updated
12/05/2014
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