Individual
GREGORIO CASTRO HEREDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4111 E TOWNE BLVD, MADISON, WI 53704-3731
(305) 515-0109
Mailing address
4111 E TOWNE BLVD, MADISON, WI 53704-3731
(305) 515-0109
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11405-125
WI
Other
Enumeration date
07/03/2025
Last updated
07/21/2025
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