Individual
RAVEN MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
6815 W CAPITOL DR, MILWAUKEE, WI 53216-2070
(414) 935-2215
Mailing address
3526 N 22ND ST, MILWAUKEE, WI 53206-1835
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/04/2022
Last updated
02/04/2022
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