Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 4177-026 | WI |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 4177-026 | WI |
NPI | 1699962241 |
---|---|
Provider Name | Mrs. Michele Marie Molina |
First Address | Neenah, WI 54956-2883 |
Second Address | Neenah, WI 54956-2883 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2007 |
Last Update Date | 27/09/2007 |