Individual
MELANIE M DICELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
W231N1440 CORPORATE CT STE 310, WAUKESHA, WI 53186-1503
(414) 773-4312
Mailing address
W231N1440 CORPORATE CT STE 310, WAUKESHA, WI 53186-1503
(414) 773-4312
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9219
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100091699
—
WI
Enumeration date
06/13/2019
Last updated
12/08/2021
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