Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 414-026 | WI |
NPI | 1033202528 |
---|---|
Provider Name | Ms. Marie Ann Maxwell-Jones |
First Address | Delafield, WI 53018-1076 |
Second Address | Jefferson, WI 53549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |