Individual
DR. RUSSELL WILLIAM KINKADE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
6214 WASHINGTON AVENUE, SUITE C 10, RACINE, WI 53406
(262) 989-5228
Mailing address
S55W29307 HOLIDAY POINT, WAUKESHA, WI 53189-9026
(262) 989-5228
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1296
WI
Other
Enumeration date
10/27/2006
Last updated
07/16/2025
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