Individual
TRICIA DE SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
1440 MONROE ST, MADISON, WI 53711-2051
(608) 262-8037
Mailing address
1440 MONROE ST, MADISON, WI 53711-2051
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
840-039
WI
Other
Enumeration date
01/20/2015
Last updated
01/20/2015
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