Individual
VIVIAN A MARINELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
5225 N IRONWOOD LN, GLENDALE, WI 53217-4909
(414) 962-9156
(414) 962-4356
Mailing address
5225 N IRONWOOD LN, GLENDALE, WI 53217-4909
(414) 962-9156
(414) 962-4356
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2026-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39671200
—
WI
Enumeration date
10/06/2006
Last updated
07/08/2007
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