Individual
MRS. STACY LEE RUDIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.E., E.C.S.E
Contact information
Practice address
3375 W BREWSTER ST, APPLETON, WI 54914-1602
(920) 749-5870
Mailing address
3375 W BREWSTER ST, APPLETON, WI 54914-1602
(920) 749-5870
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
R320000311743
WI
Other
Enumeration date
11/19/2007
Last updated
11/19/2007
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