Individual
DANIELLE LEPAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5223 E 1ST ST, SUPERIOR, WI 54880-4346
(218) 310-5999
Mailing address
5223 E 1ST ST, SUPERIOR, WI 54880-4346
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
201569
MN
224Z00000X
Occupational Therapy Assistant
Primary
4717-27
WI
Other
Enumeration date
11/29/2012
Last updated
11/29/2012
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