Individual
VICKI J. KACHACHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
3732 S 19TH ST, MILWAUKEE, WI 53221-1506
(414) 721-1817
Mailing address
3732 S 19TH ST, MILWAUKEE, WI 53221-1506
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7368-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40940000
STATE OF WISCONSIN PROVIDER NUMBER
WI
Enumeration date
06/18/2008
Last updated
06/18/2008
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