Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 2481-026 | WI |
NPI | 1952577801 |
---|---|
Provider Name | Mrs. Heather Marie Dhaseleer |
First Address | Rhinelander, WI 54501-8494 |
Second Address | Rhinelander, WI 54501-8494 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2008 |
Last Update Date | 24/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
40768600 | (05) | WI |