Provider Demographics
NPI:1174236921
Name:HABBERLEY, MICHAELA QUYN
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:QUYN
Last Name:HABBERLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHAELA
Other - Middle Name:QUYN
Other - Last Name:POLEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2004 HIGHLAND AVE STE M
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-4389
Mailing Address - Country:US
Mailing Address - Phone:715-835-5915
Mailing Address - Fax:715-835-8112
Practice Address - Street 1:2004 HIGHLAND AVE STE M
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-4389
Practice Address - Country:US
Practice Address - Phone:715-835-5915
Practice Address - Fax:715-835-8112
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-26
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10666-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional