Individual
JAMIE LYNN MOSUPYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 433-7823
(920) 433-3651
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4825-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013227537
—
WI
Enumeration date
10/18/2010
Last updated
08/21/2023
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