Provider Demographics
NPI:1568045706
Name:FLUEGEL, TERESA S
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:S
Last Name:FLUEGEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 35TH ST LOWR SUITEB
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53140-5117
Mailing Address - Country:US
Mailing Address - Phone:262-764-2459
Mailing Address - Fax:262-558-0429
Practice Address - Street 1:2901 35TH ST LOWR SUITEB
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-5117
Practice Address - Country:US
Practice Address - Phone:262-764-2459
Practice Address - Fax:262-558-0429
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health