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Individual

KIMBERLY RENEE BEACH I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
200 N PATRICK BLVD, BROOKFIELD, WI 53045-5883
(888) 754-0398
Mailing address
W849 PRIMROSE RD, GENOA CITY, WI 53128-1647
(262) 729-6009

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-312893
WI

Other

Enumeration date
08/12/2024
Last updated
08/12/2024
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