Individual
KAITLYN BORK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1011 N LYNNDALE DR STE 2D, APPLETON, WI 54914-3091
(920) 385-1420
Mailing address
320 W 8TH ST, KAUKAUNA, WI 54130-2316
(920) 359-1407
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
134452
WI
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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