Individual
MS. KIM M JAEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW SAC
Contact information
Practice address
N372 LINCOLN RD, IXONIA, WI 53036-9508
(262) 337-0641
Mailing address
N372 LINCOLN RD, IXONIA, WI 53036-9508
(262) 337-0641
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12723-131
WI
1041C0700X
Clinical Social Worker
Primary
1536-123
WI
Other
Enumeration date
11/16/2014
Last updated
02/04/2025
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