Individual
KELLY DENISE SCROGGINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2501 JEAN AVE, RACINE, WI 53404-1819
(262) 744-5362
(262) 744-5362
Mailing address
2501 JEAN AVE, RACINE, WI 53404-1819
(262) 744-5362
(262) 744-5362
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
WI
Other
Enumeration date
05/08/2025
Last updated
05/08/2025
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