Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 357-027 | WI |
NPI | 1033316609 |
---|---|
Provider Name | Ms. Joan Marie Eckrich |
First Address | Marshfield, WI 54449-1832 |
Second Address | Marshfield, WI 54449-1832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 08/07/2007 |