Individual
DEBRA CANDY KIMAIGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LPC, ICS
Contact information
Practice address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6744
(262) 638-6540
Mailing address
1717 TAYLOR AVE, RACINE, WI 53403-2405
(262) 638-6744
(262) 638-6540
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
605-125
WI
1041C0700X
Clinical Social Worker
Primary
1061-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39617400
—
WI
Enumeration date
12/06/2006
Last updated
08/20/2019
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