Individual
DEANNA P DORAISWAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2961 SAINT ANTHONY DR, GREEN BAY, WI 54311
(920) 468-0861
Mailing address
2060 E PLANK RD UNIT 3, APPLETON, WI 54915-7045
(920) 655-7340
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119005787
VA
225X00000X
Occupational Therapist
4982-026
WI
Other
Enumeration date
03/13/2012
Last updated
06/14/2018
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