Individual
XELIA LOVE FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2603 W RAWSON AVE STE 132, OAK CREEK, WI 53154-8422
(888) 754-0398
Mailing address
3041 S 35TH ST, MILWAUKEE, WI 53215-3577
(414) 242-2515
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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