Individual
JOANNE C KEMNITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
128226-121
WI
1041C0700X
Clinical Social Worker
Primary
8013-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063783900
—
WI
01
—
K400119674
MEDICARE PTAN
WI
Enumeration date
01/24/2012
Last updated
11/10/2021
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