Provider Demographics
NPI:1558420745
Name:THIES-WEBER, DONNA JEAN (MA)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JEAN
Last Name:THIES-WEBER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:JEAN
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:131 CARMICHAEL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-8271
Mailing Address - Country:US
Mailing Address - Phone:715-808-0607
Mailing Address - Fax:
Practice Address - Street 1:131 CARMICHAEL RD STE 206
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-8271
Practice Address - Country:US
Practice Address - Phone:715-808-0607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4329-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional