Provider Demographics
NPI:1982351102
Name:KREBSBACH, TERESA JEAN (APSW, LGSW)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:JEAN
Last Name:KREBSBACH
Suffix:
Gender:F
Credentials:APSW, LGSW
Other - Prefix:MRS
Other - First Name:TERESA
Other - Middle Name:JEAN
Other - Last Name:JESZEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APSW, LGSW
Mailing Address - Street 1:500 MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:WI
Mailing Address - Zip Code:54015-9668
Mailing Address - Country:US
Mailing Address - Phone:651-307-3722
Mailing Address - Fax:
Practice Address - Street 1:2501 HANLEY RD STE 201
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-8786
Practice Address - Country:US
Practice Address - Phone:534-544-5247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN14880104100000X
WI127725-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker