Individual
MRS. MARY ELIZABETH PETOSKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS/CCC-SLP
Contact information
Practice address
2900 W. OKLAHOMA AVE, MILWAUKEE, WI 53215-0000
(414) 649-7772
(414) 649-7977
Mailing address
10945 N. PORT WASHINGTON RD., SUITE 211, MEQUON, WI 53092-0000
(262) 241-8000
(262) 241-8096
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
419-154
WI
Other
Enumeration date
03/06/2012
Last updated
12/13/2021
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