Individual
KELLY POPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1218 79TH ST, KENOSHA, WI 53143-6111
(262) 658-9500
(262) 764-0751
Mailing address
1218 79TH ST, KENOSHA, WI 53143-6111
(262) 658-9500
(262) 764-0751
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4251-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100088524
—
WI
Enumeration date
01/10/2017
Last updated
11/20/2025
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