Individual
JENNA L TADYCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3129 MICHIGAN AVE, SHEBOYGAN, WI 53081-3062
(920) 459-4382
Mailing address
2341 SKYLINE DR APT 2D, SHEBOYGAN, WI 53081-5491
(906) 221-7161
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5381-27
WI
Other
Enumeration date
11/02/2017
Last updated
11/02/2017
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