Individual
MARILYNN DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6001 W CENTER ST, MILWAUKEE, WI 53210-2154
(414) 393-1099
Mailing address
2650 N 22ND ST, MILWAUKEE, WI 53206-1509
(414) 870-4919
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2141-121
WI
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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