Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 4605-027 | WI |
NPI | 1023283702 |
---|---|
Provider Name | Tracee Schuh |
First Address | Wittenberg, WI 54499-9040 |
Second Address | Wittenberg, WI 54499-9040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2008 |
Last Update Date | 24/04/2008 |