Individual
MICHELLE IDA TENUTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-0535
Mailing address
2812 LINCOLN RD, KENOSHA, WI 53143-5654
(262) 914-9565
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6334154
WI
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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