Healthcare Provider Details

I. General information

NPI: 1902713829
Provider Name (Legal Business Name): SEIDL PIAZZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 N 31ST ST
MILWAUKEE WI
53208-1902
US

IV. Provider business mailing address

4318 S TAYLOR AVE
MILWAUKEE WI
53207-5226
US

V. Phone/Fax

Practice location:
  • Phone: 414-934-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number3001030942
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: