Provider Demographics
NPI:1902581242
Name:JUGA, TERESA JEAN (MSW)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:JEAN
Last Name:JUGA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:JEAN
Other - Last Name:JUGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:N2150 KESAEHKAHTEK RD
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:WI
Mailing Address - Zip Code:54128-9602
Mailing Address - Country:US
Mailing Address - Phone:715-799-3035
Mailing Address - Fax:715-799-5056
Practice Address - Street 1:N2150 KESAEHKAHTEK RD
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:WI
Practice Address - Zip Code:54128-9602
Practice Address - Country:US
Practice Address - Phone:715-799-3835
Practice Address - Fax:715-799-5056
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13376101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)