Individual
NINA SOUKUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5225 W VLIET ST, MILWAUKEE, WI 53208-2627
(414) 475-8156
Mailing address
W59N396 HILBERT AVE, CEDARBURG, WI 53012-2445
(262) 375-8841
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
275-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42611200
—
WI
Enumeration date
08/21/2006
Last updated
07/08/2007
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