Provider Demographics
NPI:1073671681
Name:HIGUERA, JUELETTE (MSW,LCSW)
Entity Type:Individual
Prefix:
First Name:JUELETTE
Middle Name:
Last Name:HIGUERA
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 ROSS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SCHOFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54476-6110
Mailing Address - Country:US
Mailing Address - Phone:715-297-4635
Mailing Address - Fax:
Practice Address - Street 1:219 ROSS AVE STE 100
Practice Address - Street 2:
Practice Address - City:SCHOFIELD
Practice Address - State:WI
Practice Address - Zip Code:54476-6110
Practice Address - Country:US
Practice Address - Phone:715-421-9707
Practice Address - Fax:715-298-0794
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7230-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40936100Medicaid