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Individual

MARVIN A VALDEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
SAC-IT

Contact information

Practice address
1610 MILLER PARK WAY, WEST MILWAUKEE, WI 53214-3604
(414) 672-3801
(414) 672-6026
Mailing address
1610 MILLER PARK WAY, WEST MILWAUKEE, WI 53214-3604
(414) 672-3801
(414) 672-6026

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18063130
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18063130
SAC-IT
WI
Enumeration date
05/23/2019
Last updated
05/23/2019
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