Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251E1200X | Ergonomics | 1051100444 | WI |
N | 225XE1200X | Ergonomics | 1051100444 | WI |
Y | 225XH1200X | Occupational Therapist - Hand | 266-026 | WI |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 266-026 | WI |
NPI | 1144330796 |
---|---|
Provider Name | Vickie Patricia Mullins |
First Address | Manitowoc, WI 54220-4038 |
Second Address | Manitowoc, WI 54220-4038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 06/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
40855800 | (05) | WI |