Individual
KENNEDY WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
830 N 109TH ST STE 1, WAUWATOSA, WI 53226-3754
(414) 246-1448
Mailing address
9125 W SURA LN UNIT 303, GREENFIELD, WI 53228-3495
(414) 554-8443
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8174-226
WI
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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