Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 2034-26 | WI |
NPI | 1558635136 |
---|---|
Provider Name | Miss Julie Jane Holschbach |
First Address | New Berlin, WI 53151-8795 |
Second Address | Greenfield, WI 53220-2814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/02/2012 |
Last Update Date | 29/02/2012 |