Individual
VALENCIA CARRINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1314 W LA SALLE CT, GLENDALE, WI 53209-4412
(141) 482-8810
Mailing address
1314 W LA SALLE CT, GLENDALE, WI 53209-4412
(141) 482-8810
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87-4202764
—
WI
Enumeration date
05/04/2022
Last updated
02/05/2023
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