Individual
LEORA MASSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1155 N MAYFAIR RD, WAUWATOSA, WI 53226-3462
(414) 955-5990
(414) 955-6282
Mailing address
1155 N MAYFAIR RD, WAUWATOSA, WI 53226-3462
(414) 955-5990
(414) 955-6282
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
73404-20
WI
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
73404-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700316569
—
WI
Enumeration date
06/14/2017
Last updated
04/08/2024
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