Individual
MS. PATRICIA THEISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 GREENVIEW AVE, JANESVILLE, WI 53548-2800
(608) 290-7038
Mailing address
1515 GREENVIEW AVE, JANESVILLE, WI 53548-2800
(608) 290-7038
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1590022316
WI
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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