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Individual

DESIREE MOTIFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CST/CFA

Contact information

Practice address
1821 S WEBSTER AVE, GREEN BAY, WI 54301-2253
(920) 496-4700
(920) 431-1972
Mailing address
1821 S WEBSTER AVE, PO BOX 19070, GREEN BAY, WI 54301-2253
(920) 496-4700
(920) 431-1972

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
109757
NATIONAL BOARD OF SURGICAL TECHNOLOGY AND SURGICAL ASSISTING
WI
Enumeration date
12/12/2008
Last updated
12/12/2008
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