Individual
MS. MICHELLE KOZENIECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CD, CNSC
Contact information
Practice address
9200 W WISCONSIN AVE, WAUWATOSA, WI 53226-3522
(414) 805-7792
Mailing address
9200 W WISCONSIN AVE, FROEDTERT HOSPITAL, WAUWATOSA, WI 53226-3522
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2238-29
WI
Other
Enumeration date
06/01/2016
Last updated
06/13/2016
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