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Individual

AMANDA LYNN LAEDTKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CGC

Contact information

Practice address
9000 W WISCONSIN AVE, MS 716, MILWAUKEE, WI 53226-4874
(414) 266-6722
Mailing address
W9938 VIEW RIDGE LN, NEW LONDON, WI 54961-9109
(920) 378-6386

Taxonomy

Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
15833
WI

Other

Enumeration date
11/29/2012
Last updated
11/29/2012
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