Individual
JUSTINA KIMMEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
717 SOUTH BLVD STE 9, BARABOO, WI 53913-3139
(608) 630-1519
Mailing address
717 SOUTH BLVD STE 9, BARABOO, WI 53913-3139
(608) 630-1519
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
129537-121
WI
1041C0700X
Clinical Social Worker
Primary
8801
WI
Other
Enumeration date
08/03/2015
Last updated
05/27/2021
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