Individual
LISA GOUTHRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APSW
Contact information
Practice address
5703 MEMORIAL CT, WESTON, WI 54476-6502
(715) 204-9808
Mailing address
5703 MEMORIAL CT, WESTON, WI 54476-6502
(715) 204-9808
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
135023121
WI
163W00000X
Registered Nurse
Primary
0128903-030
WI
Other
Enumeration date
02/26/2007
Last updated
10/07/2025
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