Provider Demographics
NPI:1083253074
Name:HER, FWJ (MFT, QTT)
Entity Type:Individual
Prefix:MR
First Name:FWJ
Middle Name:
Last Name:HER
Suffix:
Gender:M
Credentials:MFT, QTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 RED CEDAR ST STE 3
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-2267
Mailing Address - Country:US
Mailing Address - Phone:715-308-3871
Mailing Address - Fax:888-972-4831
Practice Address - Street 1:393 RED CEDAR ST STE 3
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-2267
Practice Address - Country:US
Practice Address - Phone:715-308-3871
Practice Address - Fax:888-972-4831
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist