Individual
LARISSA MARIE BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 N PATRICK BLVD STE 250, BROOKFIELD, WI 53045-5883
(888) 754-0398
Mailing address
3120 N ACHILLES ST, MILWAUKEE, WI 53212-2036
(414) 335-4923
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
WI
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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