Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 2100-026 | WI |
NPI | 1073533378 |
---|---|
Provider Name | Mrs. Ann M Hering |
First Address | Plymouth, WI 53073-3423 |
Second Address | Sheboygan, WI 53081-3281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |