Individual
MS. LAURA CAROLINA SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
2266 N PROSPECT AVE, 4TH FLOOR, MILWAUKEE, WI 53211
(414) 962-1200
(414) 962-2305
Mailing address
PO BOX 11564, 2266 N PROSPECT AVE 4TH FLOOR, MILWAUKEE, WI 53211
(414) 962-1200
(414) 962-2305
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
10796132
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10796132
CSAC DEPT OF REGULATION
WI
05
—
39387400
—
WI
Enumeration date
10/17/2007
Last updated
10/17/2007
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