Gorecki, Kim Marie
Gorecki, Kim Marie is an sole proprietor health care provider with primary practice located at 19275 W Capitol Dr Ste 200 , Brookfield WI 53045-2734. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gorecki, Kim Marie can be contacted via phone (262) 546-7478.Contact Information
Primary practice address
19275 W Capitol Dr Ste 200
Brookfield WI 53045-2734
Phone: (262) 546-7478
Fax: (262) 373-0362
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2810-057 | Wisconsin |
Profile Details
| NPI number | 1649361775 |
|---|---|
| LBN Legal business name | Gorecki, Kim Marie |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 27th, 2006 |
| Last updated | Jan 21st, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649361775 | NPPES |
| Wisconsin | Other | 2810-057 | LP |
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