Provider Demographics
NPI:1730715848
Name:LAGRONE-MORRIS, ELSIE L
Entity type:Individual
Prefix:
First Name:ELSIE
Middle Name:L
Last Name:LAGRONE-MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8532 W CAPITOL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-1850
Mailing Address - Country:US
Mailing Address - Phone:262-765-3305
Mailing Address - Fax:
Practice Address - Street 1:8532 W CAPITOL DR STE 200
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1850
Practice Address - Country:US
Practice Address - Phone:262-765-3305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-20
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI251B0000X251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management