Individual
KAYLA DIESNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1616 W BENDER RD, GLENDALE, WI 53209-3802
(414) 228-8700
Mailing address
3939 N MURRAY AVE APT 404, SHOREWOOD, WI 53211-2318
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4845-154
WI
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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