Doctor Name: | JESSICA ROSE THERING |
NPI Number: | 1932590916 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SAC-IT, MT-BC, WMTR |
License Number: | 117 |
Business Practice Address: | 1971 Washington St Suite 200 Grafton, WI - 530242102 |
Business Phone Number: | 2623776276 |
Business Fax Number: | |
Mailing Address: | 1971 Washington St, Suite 200 GRAFTON |
State: | WI |
Postal Code: | 530242102 |
Phone Number: | 2623776276 |
Fax Number: | |
NPI Enumeration Date: | 02/11/2015 |
NPI Last Update Date: | 02/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 117 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |