Individual
MRS. TANYA LYNNE WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
620 S 76TH ST, MILWAUKEE, WI 53214-1599
(414) 988-6350
Mailing address
620 S 76TH ST, MILWAUKEE, WI 53214-1599
(414) 988-6350
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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