Individual
TINOTENDA EMILLIO CHIVENDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APSW
Contact information
Practice address
1205 S 70TH ST, STE 301, WEST ALLIS, WI 53214-3167
(414) 475-2788
Mailing address
6233 39TH AVE, KENOSHA, WI 53142-7015
(262) 652-1004
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
133090-121
WI
Other
Enumeration date
05/14/2024
Last updated
05/14/2024
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