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Individual

DIANE LUEBKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2187 S 85TH ST, WEST ALLIS, WI 53227-1747
(414) 321-2648
(414) 321-2676
Mailing address
2187 S 85TH ST, WEST ALLIS, WI 53227-1747
(414) 321-2648
(414) 321-2676

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15302-130
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15302-130
SAC-IT
WI
Enumeration date
01/30/2008
Last updated
01/30/2008
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