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Individual

DR. KIM MARIE GORECKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
19275 W CAPITOL DR STE 200, BROOKFIELD, WI 53045-2734
(262) 546-7478
(262) 373-0362
Mailing address
19275 W CAPITOL DR STE 200, BROOKFIELD, WI 53045-2734
(262) 546-7478
(262) 373-0362

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2810-057
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2810-057
LP
WI
Enumeration date
09/27/2006
Last updated
01/21/2019
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