Kelly Phoungphol
Case Manager/Care Coordinator in Milwaukee, WI. Individual provider (NPI-1).
NPI number1326462003
StatusActive
Last updated in NPPESFeb 14, 2014
Details
- NPI
- 1326462003
- Entity type
- Individual (NPI-1)
- Name
- Kelly Phoungphol
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 14, 2014
- Last updated
- Feb 14, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | WI | Yes |
Practice location
820 N Plankinton AveMilwaukee, WI 53203-1802
Phone 414-225-1573 · Fax 414-225-1575
Mailing address
820 N Plankinton AveMilwaukee, WI 53203-1802
Phone 414-225-1573 · Fax 414-225-1575
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