Healthcare Provider Details

I. General information

NPI: 1992493647
Provider Name (Legal Business Name): RAMANI KUTTY-PATEL APSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2023
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 RIVERVIEW AVE
WAUKESHA WI
53188-3631
US

IV. Provider business mailing address

514 RIVERVIEW AVE
WAUKESHA WI
53188-3631
US

V. Phone/Fax

Practice location:
  • Phone: 262-548-7678
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number129744-121
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: