MEDICARE: DR. CHRISTINA LORINE DIORIO PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	2299-057	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093988651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINA LORINE DIORIO PH.D.

Provider Business Mailing Address
First Line	:	3505 N 124TH ST
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53005-2489
Country	:	US
Telephone Number	:	414-431-4444
Fax Number	:	414-431-0858

Provider Business Practice Location Address
First Line	:	3505 N 124TH ST
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53005-2489
Country	:	US
Telephone Number	:	414-431-4444
Fax Number	:	414-431-0858

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2008
Last Update Date	:	10/13/2022

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