Individual
MS. LASHARAI TAZA RUPERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5252 N 84TH ST, MILWAUKEE, WI 53225-3502
(414) 350-1291
Mailing address
5252 N 84TH ST, MILWAUKEE, WI 53225-3502
(414) 350-1291
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/23/2013
Last updated
04/23/2013
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