Individual
JUDITH KISICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
BEHAVIORAL MEDICINE CENTER, 721 AMERICAN AVENUE SUITE 501, WAUKESHA, WI 53188
(262) 928-2396
(262) 544-1213
Mailing address
BEHAVIORAL MEDICINE CENTER, 721 AMERICAN AVENUE SUITE 501, WAUKESHA, WI 53188
(262) 928-2396
(262) 544-1213
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35592
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32060400
—
WI
Enumeration date
02/13/2006
Last updated
04/09/2013
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