Individual
PATRICIA LORRAINE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SPEECH LANGUAGE PATH
Contact information
Practice address
1108 GRANT ST, WAUKESHA, WI 53186-6321
(262) 544-5044
(262) 544-5193
Mailing address
1108 GRANT ST, WAUKESHA, WI 53186-6321
(262) 544-5044
(262) 544-5193
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
435154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42686100
—
WI
Enumeration date
04/12/2008
Last updated
04/12/2008
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