Individual
CECILIA ENRIQUEZ DIEGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9000 W SURA LN, GREENFIELD, WI 53228-3477
(414) 246-6800
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2233
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4873-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4873-154
STATE LICENSE
WI
Enumeration date
07/24/2019
Last updated
12/08/2021
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