Individual
RICHARD R KOPELKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADCIII
Contact information
Practice address
2611 12TH ST S, WISCONSIN RAPIDS, WI 54494
(715) 421-8800
(715) 421-2266
Mailing address
2611 12TH ST S, WISCONSIN RAPIDS, WI 54494
(715) 421-8800
(715) 421-2266
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1289
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39332500
—
WI
Enumeration date
11/28/2006
Last updated
07/08/2007
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