Organization
LAZRIA PRICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAZRIA TRINETTE PRICE (SAC-IT)
(262) 497-3445
Entity
Organization
Contact information
Practice address
4001 W CAPITOL DR, MILWAUKEE, WI 53216-2530
(414) 455-3879
Mailing address
4001 W CAPITOL DR, MILWAUKEE, WI 53216-2530
(414) 759-6377
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
16859
WI
Other
Enumeration date
04/11/2013
Last updated
04/12/2013
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