Provider Demographics
NPI:1659556256
Name:LAPP, PAULINE M (SAC)
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:M
Last Name:LAPP
Suffix:
Gender:F
Credentials:SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 SAYLESVILLE RD
Mailing Address - Street 2:LAWRENCE CENTER
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53189
Mailing Address - Country:US
Mailing Address - Phone:262-928-6900
Mailing Address - Fax:262-928-3815
Practice Address - Street 1:3011 SAYLESVILLE RD
Practice Address - Street 2:LAWRENCE CENTER
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53189
Practice Address - Country:US
Practice Address - Phone:262-928-6900
Practice Address - Fax:262-928-3815
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14580-130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)