Individual
TRACEY CORNELLA-CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
721 AMERICAN AVE STE 501, WAUKESHA, WI 53188-5071
(262) 928-4036
Mailing address
721 AMERICAN AVE STE 501, WAUKESHA, WI 53188-5071
(262) 928-4036
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
48673
WI
Other
Enumeration date
05/23/2006
Last updated
01/10/2019
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