Provider Demographics
NPI:1073233458
Name:EISENBRAUN, MEGHAN ROSE (MSW, APSW)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ROSE
Last Name:EISENBRAUN
Suffix:
Gender:F
Credentials:MSW, APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1846 118TH ST
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-6310
Mailing Address - Country:US
Mailing Address - Phone:715-497-8460
Mailing Address - Fax:
Practice Address - Street 1:1846 118TH ST
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-6310
Practice Address - Country:US
Practice Address - Phone:715-497-8460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI129474-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker