Individual
ELIZABETH CHARLENE MORIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DTR
Contact information
Practice address
201 N MAYFAIR RD, WAUWATOSA, WI 53226-4216
(262) 785-2155
Mailing address
2130 N 64TH ST, WAUWATOSA, WI 53213-2028
(262) 989-5622
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
925893
WI
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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