Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 2187-026 | WI |
NPI | 1003080706 |
---|---|
Provider Name | Laura Hintz |
First Address | Appleton, WI 54914-1601 |
Second Address | Appleton, WI 54914-1601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2008 |
Last Update Date | 15/04/2008 |