Individual
LISA WAKEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-1328
Mailing address
1219 N 62ND ST APT 209, WAUWATOSA, WI 53213-3075
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
WI
Other
Enumeration date
04/07/2022
Last updated
04/07/2022
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