Individual
MS. STEPHANIE KERANEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2305 SAN LUIS PL, GREEN BAY, WI 54304-5211
(920) 494-5231
Mailing address
420 5TH ST, NEENAH, WI 54956-2867
(920) 277-6974
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4715-27
WI
Other
Enumeration date
11/16/2011
Last updated
11/16/2011
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