Individual
KELLY THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
534 E GREEN BAY AVE, SAUKVILLE, WI 53080-2012
(262) 388-3700
Mailing address
1512 HICKORY CT, PORT WASHINGTON, WI 53074-2403
(262) 388-3700
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
—
—
Other
Enumeration date
10/22/2019
Last updated
10/22/2019
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