Individual
KAITLYN KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CF-SLP
Contact information
Practice address
5219 88TH AVE., KENOSHA, WI 53144
(262) 653-0850
Mailing address
5219 88TH AVE, KENOSHA, WI 53144-7468
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4464-154
WI
Other
Enumeration date
07/12/2017
Last updated
07/12/2017
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