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Individual

KATHLEEN A. KOTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
9000 W WISCONSIN AVE, FIFTH FLOOR, SUITE 510, MILWAUKEE, WI 53226-4874
(414) 266-4920
Mailing address
PO BOX 1997, M5 B510, MILWAUKEE, WI 53201-1997
(414) 266-4920

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
53989-021
WI
2084P0804X
Child & Adolescent Psychiatry Physician
H0065800
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1366572000
WI
Enumeration date
03/06/2007
Last updated
04/10/2024
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