Healthcare Provider Details

I. General information

NPI: 1992627111
Provider Name (Legal Business Name): CALYN GARZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9235 W CAPITOL DR STE 200
MILWAUKEE WI
53222-1567
US

IV. Provider business mailing address

9235 W CAPITOL DR STE 200
MILWAUKEE WI
53222-1567
US

V. Phone/Fax

Practice location:
  • Phone: 414-200-0180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9224-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: