Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 3273-026 | WI |
NPI | 1124163464 |
---|---|
Provider Name | Mrs. Jeanette Braun |
First Address | Oshkosh, WI 54904-7402 |
Second Address | Oshkosh, WI 54904-7668 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 08/07/2007 |