Provider Demographics
NPI:1164762001
Name:SCHILL, JENNIFER LEE (MFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEE
Last Name:SCHILL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:BARRONETT
Mailing Address - State:WI
Mailing Address - Zip Code:54813-9432
Mailing Address - Country:US
Mailing Address - Phone:715-645-2137
Mailing Address - Fax:
Practice Address - Street 1:203 UNITED WAY
Practice Address - Street 2:
Practice Address - City:FREDERIC
Practice Address - State:WI
Practice Address - Zip Code:54837-8938
Practice Address - Country:US
Practice Address - Phone:715-327-4402
Practice Address - Fax:715-327-4470
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI339-228106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist