Individual
DR. VICTORIA IRENE MILLER SEPULVEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., LPC, CSAC, NC
Contact information
Practice address
116 W GRAND AVE STE 104, PORT WASHINGTON, WI 53074-2242
(262) 394-1829
Mailing address
PO BOX 171009, MILWAUKEE, WI 53217-8092
(414) 837-6392
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15861-132
WI
101YP2500X
Professional Counselor
Primary
5482-125
WI
Other
Enumeration date
07/01/2014
Last updated
04/13/2022
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