Doctor Name: | ANNETTE RENEE VIELLEUX |
NPI Number: | 1053691105 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | 5466-125 |
Business Practice Address: | 10045 W Lisbon Ave Wauwatosa, WI - 532222446 |
Business Phone Number: | 4143587157 |
Business Fax Number: | 4143587158 |
Mailing Address: | 10045 W Lisbon Ave, WAUWATOSA |
State: | WI |
Postal Code: | 532222446 |
Phone Number: | 4143587157 |
Fax Number: | 4143587158 |
NPI Enumeration Date: | 08/21/2011 |
NPI Last Update Date: | 05/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 5466-125 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |