Individual
MRS. KIMBERLY MARIE MIREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
4214 SHERIDAN RD, RACINE, WI 53403-4142
(262) 515-2434
Mailing address
4736 W FOREST HOME AVE, MILWAUKEE, WI 53219-4716
(414) 306-1410
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146007081
IL
Other
Enumeration date
07/12/2005
Last updated
07/21/2008
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