Individual
MRS. MYLINDA ROSE BARISAS-MATULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2629 N 7TH ST, SHEBOYGAN, WI 53083-4932
(920) 451-5634
Mailing address
417 SAINT CLAIR AVE, SHEBOYGAN, WI 53081-3562
(920) 451-4651
(920) 451-5664
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1913-026
WI
Other
Enumeration date
04/11/2007
Last updated
07/08/2007
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