Individual
MRS. MICHELLE RENEE DAHLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1821 S STOUGHTON RD, DEAN MEDICAL CENTER, MADISON, WI 53716-2257
(608) 260-6004
(608) 260-6906
Mailing address
1821 S STOUGHTON RD, DEAN MEDICAL CENTER, MADISON, WI 53716-2257
(608) 260-6004
(608) 260-6906
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4051-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063680866
—
WI
Enumeration date
02/14/2008
Last updated
12/18/2020
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