Healthcare Provider Details

I. General information

NPI: 1962564369
Provider Name (Legal Business Name): VALERIE J LAABS SIEMON MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 06/16/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 W GLEN OAKS LN STE 204
MEQUON WI
53092-3395
US

IV. Provider business mailing address

1035 W GLEN OAKS LN STE 204
MEQUON WI
53092-3395
US

V. Phone/Fax

Practice location:
  • Phone: 414-378-9899
  • Fax:
Mailing address:
  • Phone: 414-378-9899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number43124
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2527125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: