Individual
REINA TAKAMURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1455 S 97TH ST, WEST ALLIS, WI 53214-4133
(414) 412-9229
Mailing address
1455 S 97TH ST, WEST ALLIS, WI 53214-4133
(414) 412-9229
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
128973-121
WI
Other
Enumeration date
04/21/2014
Last updated
04/21/2014
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