Individual
MRS. LISA MARIE BLAESER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
611 N BROADWAY, SUITE 105, MILWAUKEE, WI 53202-5000
(414) 431-0801
(414) 431-0804
Mailing address
1120 E LYON ST, MILWAUKEE, WI 53202-2128
(414) 270-0481
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7067-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40951000
—
WI
Enumeration date
03/27/2007
Last updated
12/08/2021
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