Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | WI |
NPI | 1023347036 |
---|---|
Provider Name | Emily Anne Rademacher |
First Address | Neenah, WI 54956-3907 |
Second Address | Berlin, WI 54923-1243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2009 |
Last Update Date | 22/12/2009 |