Individual
VALERIE M GONSALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3099 E WASHINGTON AVE, MADISON, WI 53704-4338
(773) 304-6737
Mailing address
3099 E WASHINGTON AVE, MADISON, WI 53704-4338
(773) 304-6737
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2998
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558918607
—
WI
Enumeration date
08/22/2019
Last updated
01/13/2022
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