Individual
MRS. KELLIE MARIE LANZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCCC-SLP
Contact information
Practice address
6700 N. PORT WASHINGTON RD., C/O ST. FRANCIS CHILDREN'S CENTER, GLENDALE, WI 53217-3919
(414) 351-8850
(414) 351-8846
Mailing address
6700 N. PORT WASHINGTON RD., C/O ST. FRANCIS CHILDREN'S CENTER, GLENDALE, WI 53217-3919
(414) 351-8850
(414) 351-8846
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2960-154
WI
Other
Enumeration date
08/05/2007
Last updated
11/22/2011
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