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Individual

KIMBERLY KOPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1902 MEAD AVE, SHEBOYGAN, WI 53081-6140
(920) 458-8333
(920) 458-6837
Mailing address
528 ACACIA DR, GRAFTON, WI 53024-9610
(262) 618-4729

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3143154
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42595900
WI
Enumeration date
01/26/2010
Last updated
01/26/2010
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