Individual
KATHRYN E KOENIG-LEUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1205 S 70TH ST STE 301, WEST ALLIS, WI 53214-3171
(414) 475-2788
(414) 476-8695
Mailing address
1205 S 70TH ST, WEST ALLIS, WI 53214-3167
(414) 475-2788
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6571
WI
103T00000X
Psychologist
Primary
3757-57
WI
Other
Enumeration date
08/09/2017
Last updated
09/23/2020
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