Individual
MRS. SUSAN ELIZABETH LESAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
9455 W WATERTOWN PLANK RD, WAUWATOSA, WI 53226-3559
(414) 257-7583
Mailing address
9455 W WATERTOWN PLANK RD, WAUWATOSA, WI 53226-3559
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
753-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40638400
—
WI
Enumeration date
05/12/2008
Last updated
05/12/2008
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