Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 1161-26 | WI |
NPI | 1003079237 |
---|---|
Provider Name | Ms. Patricia Mary Harkensee |
First Address | Mequon, WI 53097-3668 |
Second Address | Mequon, WI 53097-3668 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2008 |
Last Update Date | 08/07/2008 |