Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 2869-026 | WI |
NPI | 1992750988 |
---|---|
Provider Name | Mrs. Renee E Rettler |
First Address | Wauwatosa, WI 53213-1944 |
Second Address | Milwaukee, WI 53211-2906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 08/07/2007 |