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Individual

MS. MARY JO MICHELS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD, CD

Contact information

Practice address
615 W MORELAND BLVD, WAUKESHA, WI 53188-2462
(262) 896-8400
(262) 970-6670
Mailing address
615 W MORELAND BLVD, WAUKESHA, WI 53188-2462
(262) 896-8400
(262) 970-6670

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
836-29
WI

Other

Enumeration date
06/29/2012
Last updated
06/29/2012
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