Individual
LETICIA G VALLEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-4200
Mailing address
5627 S 25TH ST, MILWAUKEE, WI 53221-4219
(414) 625-0261
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3753-57
WI
Other
Enumeration date
06/21/2019
Last updated
01/18/2021
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