Individual
LAKETA TREADWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CBRF,
Contact information
Practice address
3617 W DOUGLAS AVE, MILWAUKEE, WI 53209-3619
(414) 841-6453
Mailing address
3617 W DOUGLAS AVE, MILWAUKEE, WI 53209-3619
(414) 841-6453
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
174200000X
Meals Provider
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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