Individual
MARY OGNENOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3200 PLEASANT VALLEY RD, WEST BEND, WI 53095-9274
(262) 677-6805
(262) 677-6801
Mailing address
151 N GERMAN ST, MAYVILLE, WI 53050-1311
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1760-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40814700
—
WI
Enumeration date
01/10/2007
Last updated
07/09/2007
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