Grizzle, Kenneth L

Grizzle, Kenneth L is an individual health care provider with primary practice located at 13800 W North Ave Child Development Center Of Chw, Brookfield WI 53005-4977. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as his primary health care specialty. Grizzle, Kenneth L can be contacted via phone (262) 432-6600.

Contact Information

Primary practice address
13800 W North Ave Child Development Center Of Chw Brookfield WI 53005-4977
Phone: (262) 432-6600
Fax: (262) 432-6604
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 2187 Wisconsin

Profile Details

NPI number 1912958737
LBN Legal business name Grizzle, Kenneth L
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2006
Last updated Nov 21st, 2013 - about 12 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1912958737 NPPES
Other 005000215G HUMANA
MEDICAID 1912958737 HUMANA

Popular Providers