Individual
MISS SHAWNA PENELOPE VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1425 MACKINAC AVE, APT # 501, SOUTH MILWAUKEE, WI 53172
(262) 215-3279
Mailing address
1425 MACKINAC AVE, SOUTH MILWAUKEE, WI 53172-3043
(262) 215-3279
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5184-26
WI
Other
Enumeration date
12/27/2012
Last updated
03/20/2023
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