Individual
CHIQUITA SHARDA PRYOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10130 W TOWER AVE, MILWAUKEE, WI 53224-2914
(414) 617-2188
Mailing address
10130 W TOWER AVE, MILWAUKEE, WI 53224-2914
(414) 617-2188
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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