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General NPI Number Information
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NPI Number | 1780023663
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Entity Type | Individual
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Provider Name | GABRIELA PALOMINO MCCOMB LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/24/2013
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 12065 W JANESVILLE RD STE 300B
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City | HALES CORNERS
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State | WI
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Zip | 53130-2368
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Country | US
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Telephone | 414-207-6688
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Fax |
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Provider Business Mailing Address
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Address Line | 12229 W MCSHANE RD
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City | FRANKLIN
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State | WI
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Zip | 53132-2003
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Country | US
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Telephone | 414-207-6688
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9581
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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