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Individual

LYDIA ANN MENDEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SAC-IT

Contact information

Practice address
3703 N RICHARDS ST, MILWAUKEE, WI 53212
(414) 967-7006
Mailing address
1730 W WASHINGTON ST, MILWAUKEE, WI 53204-2066
(262) 501-5962

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18748-130
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor

Other

Enumeration date
01/09/2019
Last updated
01/09/2019
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