Provider Demographics
NPI:1346949690
Name:FLUEGGE, MAYA (LGSW)
Entity Type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:FLUEGGE
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:MAYA
Other - Middle Name:
Other - Last Name:BUDIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2136 ARLINGTON TRL APT 4
Mailing Address - Street 2:
Mailing Address - City:NORTH MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56003-7505
Mailing Address - Country:US
Mailing Address - Phone:608-633-8831
Mailing Address - Fax:
Practice Address - Street 1:2136 ARLINGTON TRL APT 4
Practice Address - Street 2:
Practice Address - City:NORTH MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56003-7505
Practice Address - Country:US
Practice Address - Phone:608-633-8831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN31800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker