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Individual

DR. KIP H ZIRKEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1707 MAIN ST, LA CROSSE, WI 54601-4200
(608) 785-0001
(608) 785-0002
Mailing address
1707 MAIN ST, LA CROSSE, WI 54601-4200
(608) 785-0001
(608) 785-0002

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
781
WI
103TF0200X
Forensic Psychologist
781
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13G9521
BCBS-MN
MN
01
31097
NAT. REGIS. OF H.C. PROV.
WI
05
39018600
WI
05
852578100
MN
01
HP69927
HEALTHPARTNERS
Enumeration date
01/26/2007
Last updated
07/29/2010
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