Individual
DR. CAROL LYNN MORESCO-GONIU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
7733 W BURLEIGH ST, MILWAUKEE, WI 53222-5003
(262) 347-8848
Mailing address
N33W23374 GREENBRIAR CT, PEWAUKEE, WI 53072-5721
(627) 819-8972
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
Primary
1151-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06146328001
BLUE CROSS BLUE SHIELD
WI
05
—
39106900
—
WI
Enumeration date
05/19/2006
Last updated
03/06/2024
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