Individual
JUDY A WALZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10500 NORTH PORT WASHINGTON ROAD, MEQUON, WI 53092
(262) 240-0427
(262) 240-0429
Mailing address
10500 NORTH PORT WASHINGTON ROAD, MEQUON, WI 53092
(262) 240-0427
(262) 240-0429
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
47238030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40939000
—
WI
Enumeration date
11/06/2006
Last updated
07/08/2007
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