Individual
MARY LOUISE DITORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
W227N6103 SUSSEX RD, SUSSEX, WI 53089-3969
(414) 566-8140
Mailing address
W227N6103 SUSSEX RD, SUSSEX, WI 53089-3969
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
79478-30
WI
Other
Enumeration date
01/30/2020
Last updated
01/30/2020
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