Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 6456-26 | WI |
N | 225XP0200X | Occupational Therapist - Pediatrics | 6456-26 | WI |
NPI | 1023575065 |
---|---|
Provider Name | Drake Allen Kessler |
First Address | Rice Lake, WI 54868-9721 |
Second Address | Eau Claire, WI 54701-6105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2019 |
Last Update Date | 28/12/2021 |