Individual
SAMANTHA M KOVATCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1300 N JACKSON ST, MILWAUKEE, WI 53202-2602
(414) 467-1548
(414) 225-1346
Mailing address
552 N 62ND ST, WAUWATOSA, WI 53213-4170
(920) 207-9566
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9677-123
WI
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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