Individual
KRISTIN KOPPERUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8901 W LINCOLN AVE, WEST ALLIS, WI 53227-2409
(414) 328-6633
Mailing address
8901 W LINCOLN AVE, WEST ALLIS, WI 53227-2409
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6702-154
WI
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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