| Kazoua Kue, | |
|
620 W Brown St, Waupun, WI 53963-1702 | |
| (920) 324-7600 | |
| Not Available |
| Full Name | Kazoua Kue |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 620 W Brown St, Waupun, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144963935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 12073-123 (Wisconsin) | Primary |
| Entity Name | Agnesian Healthcare Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346228541 PECOS PAC ID: 1658289624 Enrollment ID: O20031104000263 |
| Mailing Address | Practice Location Address |
|---|---|
| Kazoua Kue, 620 W Brown St, Waupun, WI 53963-1702 Ph: (920) 324-7600 | Kazoua Kue, 620 W Brown St, Waupun, WI 53963-1702 Ph: (920) 324-7600 |
Lila L Roberts-bird Dba Liberty Counseling, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 315 E Jefferson St, Waupun, WI 53963 Phone: 920-210-7181 Fax: 920-324-5700 | |
Jeffrey J Campbell, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 620 W Brown St, Waupun, WI 53963 Phone: 920-324-7600 | |
Richard Frank Eckerstorfer, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1208 South Watertown Street, Waupun, WI 53963 Phone: 920-324-4358 Fax: 920-324-4737 |