Provider Demographics
NPI:1487670972
Name:DUGAN, STEFANIE B N (MS, CGC)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:B N
Last Name:DUGAN
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 N 18TH ST
Mailing Address - Street 2:PO BOX 2178
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53233-2121
Mailing Address - Country:US
Mailing Address - Phone:414-937-6126
Mailing Address - Fax:414-937-6202
Practice Address - Street 1:638 N 18TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-2121
Practice Address - Country:US
Practice Address - Phone:414-937-6126
Practice Address - Fax:414-937-6202
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS