Individual
DEIA LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3312 N 46TH ST, MILWAUKEE, WI 53216-3331
(414) 350-3641
Mailing address
3312 N 46TH ST, MILWAUKEE, WI 53216-3331
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5467125
WI
Other
Enumeration date
09/01/2015
Last updated
09/01/2015
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