Individual
MICHELLE M ALTENHOFEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
635 COUNTY RD Q, AMHERST, WI 54406-9151
(715) 630-8701
Mailing address
6365 COUNTY ROAD Q, AMHERST, WI 54406-9151
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2912
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2912
WI LICENSE #
WI
Enumeration date
03/23/2007
Last updated
05/18/2018
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