Provider Demographics
NPI:1518849454
Name:KLIMEK, GRACE ANN
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:ANN
Last Name:KLIMEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N2270 STATE ROAD 67
Mailing Address - Street 2:
Mailing Address - City:WALWORTH
Mailing Address - State:WI
Mailing Address - Zip Code:53184-5633
Mailing Address - Country:US
Mailing Address - Phone:414-510-6086
Mailing Address - Fax:
Practice Address - Street 1:N2270 STATE ROAD 67
Practice Address - Street 2:
Practice Address - City:WALWORTH
Practice Address - State:WI
Practice Address - Zip Code:53184-5633
Practice Address - Country:US
Practice Address - Phone:414-510-6086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6967-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist