Individual
MISS DANIELLE LEE LEMKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, LAT
Contact information
Practice address
W4793 SCHONFELD LN, PESHTIGO, WI 54157-9696
(920) 373-3226
Mailing address
W4793 SCHONFELD LN, PESHTIGO, WI 54157-9696
(920) 373-3226
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1312-39
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1312-39
WISCONSIN STATE LICENSURE
WI
01
—
2000002358
BOARD OF CERTIFICATION - ATHLETIC TRAINING
—
Enumeration date
11/17/2015
Last updated
02/04/2020
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