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1487141099
DETRA FERGUSON
MILWAUKEE, WI
NPI
1487141099
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2018-04-18
Last Update Date
2018-04-18
Business Address
Miss DETRA FERGUSON
11805 W HAMPTON AVE STE 103
MILWAUKEE, WI 53225-3612
Phone number: 414-213-3966
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Mailing Address
Miss DETRA FERGUSON
11805 W HAMPTON AVE STE 103
MILWAUKEE, WI 53225-3612
Phone number: 414-213-3966
Copy
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