Individual
BETSY A KENDZIORSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1317 W GRAND AVE, PORT WASHINGTON, WI 53074-2075
(262) 284-5789
(262) 284-5907
Mailing address
1317 W GRAND AVE, PORT WASHINGTON, WI 53074-2075
(262) 284-5789
(262) 284-5907
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2806-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39256100
—
WI
Enumeration date
05/20/2006
Last updated
10/18/2007
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