Individual
GABRIELA DIEGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2906 S 20TH ST, MILWAUKEE, WI 53215-3732
(414) 672-1353
(414) 672-4265
Mailing address
PO BOX 778789, CHICAGO, IL 60677-8789
(414) 672-1353
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
7405-123
WI
1041C0700X
Clinical Social Worker
Primary
7405-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43730300
—
WI
Enumeration date
01/03/2008
Last updated
06/27/2023
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