Individual
WANDA AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5670 N 39TH ST, MILWAUKEE, WI 53209-3902
(414) 915-4716
Mailing address
5670 N 39TH ST, MILWAUKEE, WI 53209-3902
(414) 915-4716
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
05/03/2022
Last updated
05/03/2022
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