Individual
KATHLEEN KAY FALK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3506 WASHINGTON RD, KENOSHA, WI 53144-1654
(262) 653-3814
Mailing address
1730 15TH AVE, APT. # 9, KENOSHA, WI 53140-4560
(262) 551-8003
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
11-27
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40589300
—
WI
Enumeration date
05/16/2008
Last updated
10/25/2013
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