Individual
ANN K KOLOCEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
200 FRONT ST, SUITE 3D, BEAVER DAM, WI 53916-1667
(920) 885-2780
(920) 885-2788
Mailing address
200 FRONT ST, SUITE 3D, BEAVER DAM, WI 53916-1667
(920) 885-2780
(920) 885-2788
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1935-57
WI
103TC0700X
Clinical Psychologist
1935057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39689100
—
WI
Enumeration date
07/24/2006
Last updated
08/16/2021
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