Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XP0200X | Occupational Therapist - Pediatrics | 2953-026 | WI |
NPI | 1023141561 |
---|---|
Provider Name | Diane Musser |
First Address | Madison, WI 53717-1040 |
Second Address | Madison, WI 53717-1040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 08/07/2007 |