Individual
MRS. LISA ANN PURTUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2814 S 108TH ST, WEST ALLIS, WI 53227-3224
(920) 926-0101
Mailing address
23 W SCOTT ST, FOND DU LAC, WI 54935-2342
(920) 926-0101
(920) 926-0060
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18388-130
WI
Other
Enumeration date
02/14/2019
Last updated
02/04/2020
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