Individual
CARLA FRIEDA FUENTESBUENDIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.A.S. SAC
Contact information
Practice address
2422 N GRANDVIEW BLVD, WAUKESHA, WI 53188-6105
(262) 549-6600
Mailing address
2422 N GRANDVIEW BLVD, WAUKESHA, WI 53188-6105
(262) 549-6600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15928-131
WI
Other
Enumeration date
11/24/2014
Last updated
12/01/2014
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