Individual
MS. LISA MARIE MLODZIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D, CGP, FASCP
Contact information
Practice address
1316 30TH CT, KENOSHA, WI 53144-3064
(262) 553-2145
(262) 553-2145
Mailing address
1316 30TH CT, KENOSHA, WI 53144-3064
(262) 553-2145
(262) 553-2145
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
12249
WI
1835P1200X
Pharmacotherapy Pharmacist
114364-9
MN
Other
Enumeration date
12/01/2011
Last updated
12/01/2011
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