Individual
MS. MARY QUADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
900 RIDGE ST, STOUGHTON, WI 53589-1864
(608) 873-2292
Mailing address
900 RIDGE ST, STOUGHTON, WI 53589-1864
(608) 873-2292
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2721-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40520400
—
WI
Enumeration date
05/07/2008
Last updated
05/07/2008
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