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Individual

MRS. BETTY JEAN DANIELS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CERTIFIED MED TECH

Contact information

Practice address
2514 N 36TH ST, MILWAUKEE, WI 53210-3041
(414) 628-3853
Mailing address
2514 N 36TH ST, MILWAUKEE, WI 53210-3041
(414) 628-3853

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
NA205392
WI
171W00000X
Contractor
NA205392
WI

Other

Enumeration date
02/09/2013
Last updated
02/09/2013
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