Individual
MISS SEDORIA OUTLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
4828 W FOND DU LAC AVE, MILWAUKEE, WI 53216-2323
(414) 899-0109
Mailing address
P O BOX 153, MILWAUKEE, WI 53201
(414) 899-0109
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
218226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
218226
LICENSE
WI
Enumeration date
05/07/2010
Last updated
05/07/2010
About Stedi
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