Individual
JENNY MARIE WIEDMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
100 MAIN ST STE 300, MENASHA, WI 54952-3287
(920) 967-1400
Mailing address
W7230 MOONLIGHT DR, GREENVILLE, WI 54942-8409
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5488-27
WI
Other
Enumeration date
05/12/2026
Last updated
05/12/2026
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