Individual
DR. KRISTA SUPINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
333 W BROWN DEER RD UNIT G1202, MILWAUKEE, WI 53217-2372
(414) 745-9325
Mailing address
333 W BROWN DEER RD UNIT G1202, MILWAUKEE, WI 53217-2372
(414) 745-9325
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3451
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100066773
—
WI
01
—
K400379168
MEDICARE
WI
Enumeration date
04/08/2014
Last updated
08/23/2024
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