Individual
MRS. KIMBERLY S WEBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, APSW
Contact information
Practice address
6121 GREEN BAY RD, SUITE 220, KENOSHA, WI 53142-2926
(262) 652-7222
(262) 652-1734
Mailing address
6121 GREEN BAY RD, SUITE 220, KENOSHA, WI 53142-2926
(262) 652-7222
(262) 652-1734
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2172-121
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11595082
CAQH PROVIDER ID
WI
05
—
40977300
—
WI
Enumeration date
07/14/2006
Last updated
07/08/2007
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