Individual
DR. IRENE KOSTIWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2818 N 68TH ST, MILWAUKEE, WI 53210-1205
(502) 216-5664
Mailing address
2818 N 68TH ST, MILWAUKEE, WI 53210-1205
(502) 216-5664
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3225-57
WI
Other
Enumeration date
10/24/2014
Last updated
10/24/2014
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