Healthcare Provider Details

I. General information

NPI: 1467369215
Provider Name (Legal Business Name): KATRIYA GIOMBI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 W LAPHAM BLVD
MILWAUKEE WI
53204-3428
US

IV. Provider business mailing address

5225 W VLIET ST
MILWAUKEE WI
53208-2627
US

V. Phone/Fax

Practice location:
  • Phone: 414-902-9200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: