Individual
MRS. LINDA LUSTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS ART THERAPY
Contact information
Practice address
10229 W GREENFIELD AVE, WEST ALLIS, WI 53214
(414) 453-6330
(414) 453-6523
Mailing address
10229 W GREENFIELD AVE, WEST ALLIS, WI 53214
(414) 453-6330
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2531125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39692400
—
WI
Enumeration date
09/06/2006
Last updated
07/08/2007
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