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Individual

MS. KATHRYN L WEEKS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
4103 60TH ST, KENOSHA, WI 53144-2509
(262) 652-3000
Mailing address
15908 N GORHAM LN, WADSWORTH, IL 60083-9414
(847) 395-6988
(847) 395-6989

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
536-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
030452095018
BCBS-BILLING PROVIDER
WI
05
40968900
WI
05
42233900
WI
01
7069698
AETNA PROVIDER NUMBER
WV
Enumeration date
06/13/2006
Last updated
07/09/2007
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