Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 3360-26 | WI |
NPI | 1003282252 |
---|---|
Provider Name | Ann Morley |
First Address | Cuba City, WI 53807-1056 |
Second Address | Cuba City, WI 53807-1056 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2015 |
Last Update Date | 11/08/2015 |