Provider Information for 1154143295
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KATHRYN STOCKS LPC, SAC-IT, NCC
Sex: Female
NPI: 1154143295
Last Updated: 2024-10-29
Certification Date: 2024-10-29
Certification Date: 2024-10-29
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1154143295 | ||||||||
| Enumeration Date | 2024-10-29 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4350 W DEER RUN DR APT 101 BROWN DEER, WI 53223-6410 United States Phone: 414-559-0054 | Fax: | ||||||||
| Primary Practice Address | 4530 N OAKLAND AVE WHITEFISH BAY, WI 53211-1215 United States Phone: 414-559-0054 | Fax: | ||||||||
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