Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 3445-026 | WI |
NPI | 1215070909 |
---|---|
Provider Name | Sarah L Konzak |
First Address | Cedar Grove, WI 53013-1679 |
Second Address | Cedar Grove, WI 53013-1679 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 08/12/2021 |