Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 5201009588 | MI |
N | 225XL0004X | Low Vision | 6429 | WI |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 6429 | WI |
N | 225XR0403X | Driving and Community Mobility | 6429 | WI |
NPI | 1508369216 |
---|---|
Provider Name | Jennifer Lynne Hauer |
First Address | West Allis, WI 53227-2409 |
Second Address | West Allis, WI 53227-2409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2018 |
Last Update Date | 18/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6429 | STATE LICENSE (01) | WI |