Individual
THERESA A MIELKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 E BURLEIGH ST, MILWAUKEE, WI 53212-2119
(800) 438-1772
(262) 345-5562
Mailing address
W175N11120 STONEWOOD DR, GERMANTOWN, WI 53022-4799
(800) 438-1772
(262) 345-5562
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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