Organization
FOX VALLEY MENTAL HEALTH, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA LUISA BALDOMERO-CONCEPCION M.D. (PSYCHIATRIST)
(920) 203-5742
Entity
Organization
Contact information
Practice address
2924 SCENIC DR, OSHKOSH, WI 54904-7641
(920) 203-5742
Mailing address
2924 SCENIC DR, OSHKOSH, WI 54904-7641
(920) 203-5742
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
43051-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639239486
NPI
WI
Enumeration date
02/12/2007
Last updated
08/22/2020
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