Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 3451-026 | WI |
NPI | 1114917994 |
---|---|
Provider Name | Ms. Amanda J Kuglitsch |
First Address | Milwaukee, WI 53226-1409 |
Second Address | Milwaukee, WI 53226-1409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2005 |
Last Update Date | 05/03/2014 |