Healthcare Provider Details

I. General information

NPI: 1992614887
Provider Name (Legal Business Name): COLIBRI PSYCHOLOGY GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 N WATER ST STE 509
MILWAUKEE WI
53202-2086
US

IV. Provider business mailing address

1661 N WATER ST STE 509
MILWAUKEE WI
53202-2086
US

V. Phone/Fax

Practice location:
  • Phone: 414-928-7895
  • Fax:
Mailing address:
  • Phone: 414-928-7895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. LETICIA G VALLEJO
Title or Position: OWNER, PSYCHOLOGIST
Credential: PHD
Phone: 414-625-0261