Individual
MRS. MIRIAM E CORONA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CSAC
Contact information
Practice address
5910 39TH AVE, KENOSHA, WI 53144-2738
(262) 833-5999
(262) 357-8431
Mailing address
1920 90TH ST, STURTEVANT, WI 53177-1806
(414) 554-8540
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16627-132
WI
101YP2500X
Professional Counselor
Primary
8781-125
WI
Other
Enumeration date
10/09/2018
Last updated
04/03/2025
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