Individual
MARIA KATIA VINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,GC
Contact information
Practice address
532 W PRAIRIE ST, COLUMBUS, WI 53925-1350
(608) 690-8655
Mailing address
532 W PRAIRIE ST, COLUMBUS, WI 53925-1350
(608) 217-1030
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
1519-61
WI
170300000X
Genetic Counselor (M.S.)
Primary
GCP-T-10245495
OR
170300000X
Genetic Counselor (M.S.)
GP61602945
WA
Other
Enumeration date
07/24/2024
Last updated
01/02/2025
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