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General NPI Number Information
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NPI Number | 1184103731
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Entity Type | Individual
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Provider Name | JAIME KAWCZYNSKI
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Gender | Female
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 08/13/2018
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Provider Practice Location Address
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Address Line | 12970 W BLUEMOUND RD
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City | ELM GROVE
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State | WI
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Zip | 53122-2607
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Country | US
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Telephone | 262-780-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 5077 W CARDINAL LN
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City | FRANKLIN
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State | WI
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Zip | 53132-2298
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Country | US
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Telephone | 414-801-5246
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4037-226
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License Number State | WI
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