Individual
MS. LISA KOSMICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1969 W HART RD, BELOIT, WI 53511-2230
(608) 364-5115
Mailing address
1969 W HART RD, BELOIT, WI 53511-2230
(608) 364-5115
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
208-156
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208-156
WI LICENSE
WI
Enumeration date
01/15/2010
Last updated
01/15/2010
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