# JEANNE H. MATHER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northern Lights Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770798274
- **Authorized official:** JEANNE H MATHER (OWNER)
- **Authorized official phone:** (715) 356-9729

## Contact information

- **Practice address:** 1256 BRANDY LAKE RD, ARBOR VITAE, WI 54568-9218
- **Practice address phone:** (715) 356-9729
- **Practice address fax:** (715) 358-5209
- **Mailing address:** PO BOX 827, 1256 BRANDY LAKE ROAD, ARBOR VITAE, WI 54568-0827
- **Mailing address phone:** (715) 356-9729
- **Mailing address fax:** (715) 358-5209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 224Z00000X | Occupational Therapy Assistant | — | NULL | — |
| 224Z00000X | Occupational Therapy Assistant | — | — | — |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225200000X | Physical Therapy Assistant | — | NULL | — |
| 225200000X | Physical Therapy Assistant | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 05/10/2007
- **Last updated:** 07/01/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 41228400 | — | WI |